Intracranial atherosclerotic
stenosis (ICAS) contributes to nearly 50% of
stroke in China, especially in patients with
hypertension. Urine
albumin-to-
creatinine ratio (ACR) has been related to
stroke and other atherosclerotic
cardiovascular diseases. However, there is limited information about the association of ACR and early impairment of cerebral vessels. Hereby we assessed the association of ICAS with ACR, estimated glomerular filtration rate (eGFR), and dipstick
proteinuria in a
stroke-free hypertensive population. We included 889
hypertension patients aged ≥60 years without prior
stroke. Computed tomography angiography was performed to detect ICAS. ACR and dipstick
proteinuria were tested from a random spot urine. eGFR was calculated using the CKD-EPI equation. Logistic regression was carried out to analyze the association of renal function with the presence, extent, and lesion number of ICAS. Elevated ACR (≥30 mg/g) was associated with ICAS after adjustment of confounding factors (odds ratio (OR) = 1.66, 95% confidence interval (CI): 1.21-2.29). Patients with elevated ACR were more prone to develop moderate-to-severe
stenosis (OR = 1.57, 95% CI: 1.16-2.14) and more lesions (OR = 1.58, 95% CI: 1.16-2.15). Such association was independent of previously identified cardiovascular risk factors. No significant association was detected between ICAS and dipstick
proteinuria or eGFR after adjustment. Our findings suggested that elevated ACR was associated with asymptomatic ICAS in an aged
stroke-free hypertensive population.