Hemodynamic alterations and urinary albumin excretion in patients with essential hypertension.

Salt-sensitive animals as well as patients with essential hypertension appear to have a greater propensity to develop renal disease as a consequence of hypertension. They also manifest an abnormal renal hemodynamic adaptation to changes in dietary sodium intake and blood pressure. This suggests that the two may be related. Some patients with essential hypertension manifest an increase in urinary albumin excretion (UAE). It is uncertain whether this is more common in salt-sensitive patients and whether it represents a marker for progressive renal disease. The effect of antihypertensive agents on UAE varies substantially depending on the agent used, and it is not necessarily related to the antihypertensive action. Whether antihypertensive agents that more effectively reduce UAE may also result in greater renal protective effects remains to be established.