Can a simple electrocardiographic parameter help identify early renal microvascular involvement in patients with hypertension? P-wave peak time (PWPT), a marker of atrial conduction delay and structural remodeling, has been associated with elevated left atrial pressure and diastolic dysfunction. Albuminuria, reflecting renal microvascular damage, has also been linked to subclinical cardiac dysfunction.

The study, published in Postgraduate Medicine, prospectively enrolled 367 patients with hypertension categorized into albuminuria-negative (n = 257; urinary albumin-to-creatinine ratio [UACR] < 30 mg/g) and albuminuria-positive (n = 110; UACR > 30 mg/g) groups based on spot UACR ratio. Comprehensive laboratory, demographic, echocardiographic, and electrocardiographic data were collected and compared between groups.

Patients with albuminuria had significantly prolonged PWPT (48 ± 11 ms vs 39 ± 9 ms; P < 0.001). Along with left atrial volume index, HbA1c, and heart rate, PWPT was independently associated with albuminuria (OR 2.688; 95% CI 1.969–3.672; P < 0.001). PWPT demonstrated the highest discriminatory power (AUC 0.771), with 76.4% sensitivity, 68.1% specificity, and a cutoff value >42 ms.

The findings indicate an independent association between PWPT and albuminuria in patients with hypertension. PWPT may serve as a noninvasive marker associated with early renal microvascular involvement.