Purpose: There have been few studies on gender difference in the impact of a urine albumin-to-creatinine ratio (UACR) within the normal range on the risk of hypertension. We evaluated whether the association between the UACR below the microalbuminuria range and the incident risk of hypertension is different between men and women. Materials and Methods: A total of 1173 individuals (442 men and 731 women) aged 40 to 70 years without hypertension was examined at baseline (2005–2008) and followed (2008–2011). We defined the UACR as the amount of albumin (mg/dL) divided by creatinine (g/dL) in randomly voided urine. The subjects were classified according to UACR tertile. Results: During an average of 2.6 years of follow-up, 57 men (12.9%) and 66 women (9.0%) developed hypertension. In multivariable-adjusted models, the odds ratio for new-onset hypertension comparing the highest and lowest tertiles of UACR was 1.83 [95% confidence interval (CI) 0.85–3.94] in men and 2.69 (95% CI 1.27–5.73) in women. In stratified analyses by menopausal status, higher tertiles of UACR were associated with an increased risk of incident hypertension in postmenopausal women. Conclusion: Higher normal UACR levels were associated with an increased risk of incident hypertension in women. The UACR could have a clinical role in predicting the development of hypertension.
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