Soluble receptor for advanced glycation end-product levels are related to albuminuria and arterial stiffness in essential hypertension

Background and aims: Emerging evidence suggests that the soluble receptor for advanced glycation end-products (sRAGE) is implicated in the development of vascular disease. We investigated the interrelationships of sRAGE with albumin to creatinine ratio (ACR) and arterial stiffness in essential hypertension. Methods and results: In 309 untreated non-diabetic hypertensives, ACR values were determined as the mean of three non-consecutive morning spot urine samples and aortic stiffness was evaluated on the basis of carotid to femoral pulse wave velocity (c-f PWV). In all subjects, venous blood sampling was performed for the estimation of sRAGE levels. Patients with low (n = 155) compared to those with high sRAGE values (n = 154) had greater 24-h systolic BP (140 +/- 8 vs. 134 +/- 7 mmHg, p < 0.0001), exhibited higher ACR (36.3 +/- 51.6 vs. 17.2 +/- 1.2 mg g(-1), p < 0.0001) and c-f PWV (8.3 +/- 1.5 vs. 7.8 +/- 1.1 m s(-1), p = 0.003), independently of confounding factors. Multiple regression analyses revealed that age, male sex, 24-h systolic BP and sRAGE were the 'independent correlates' of ACR (R-2 = 0.493, p < 0.0001), while age, 24-h systolic BP and sRAGE were the 'independent correlates' of c-f PWV (R-2 = 0.428, p < 0.0001). Conclusion: In hypertensives, decreased sRAGE levels are accompanied by pronounced albuminuria and arterial stiffening. The association of sRAGE with ACR and c-f PWV suggests involvement of sRAGE in the progression of hypertensive vascular damage. (C) 2011 Elsevier B.V. All rights reserved.