Microalbuminuria is associated with both an increased prevalence of cardiovascular risk factors and greater renal and cardiovascular morbidity. We questioned whether in the general population such associations can be found at lower levels of urinary
albumin excretion than that of classically defined microalbuminuria. To that purpose urinary
albumin concentration was measured in 40619 subjects aged 28 to 75 years. The subjects filled in a questionnaire on cardiovascular risk factors and events and were divided in deciles according to their urinary
albumin concentration. Smoking was associated with
albuminuria in the fifth or higher decile of urinary
albumin concentration, that is with an
albumin concentration of 5.1 mg/l and higher. The lower cut-off point for a positive association with
hypertension was 8.8 mg/l, and for diabetes 11.2 mg/l. Family history for
cardiovascular disease and hyperlipidaemia were not associated with
albuminuria. We conclude that urinary
albumin concentrations far below the microalbuminuric range are associated with increased prevalence of established cardiovascular risk factors. Family history for
cardiovascular disease and hyperlipidaemia seems to behave differently. These data emphasize the need for more studies on the impact of
albuminuria on the prediction of cardiovascular and renal disease in the general population.