Cardiovascular disease (CVD) is the major cause of morbidity and mortality in people with impaired renal function and End Stage Renal Disease. In patients with Type 2 Diabetes, microalbuminuria is an early sign of glomerular damage, and reflects a vascular damage in the organism. Ibsen et al (1) shows that baseline level of albuminuria is a powerful predictor for subsequent risk for cardiovascular complications in patients with essential hypertension.
Epidemiologic evidence shown that albuminuria can predict cardiovascular increase morbidity and mortality independent from other risk factors. Exist a direct relationship between protein excretion and myocardial infraction or cerebrovascular disease.
Gerstein et al (2) remarks that microalbuminuria it’s a powerful predictor of major cardiovascular disease (myocardial infraction, stroke and death) in diabetics and non-diabetics patients. The EPIC-Norfolk study detects an increased vascular risk in general population with microalbuminuria (3).
Microalbuminuria seems to correlate with various cardiac abnormalities and diseases, including left ventricular (LV) dysfunction and hypertrophy, electrocardiographic abnormalities, and ischemic heart disease (IHD). The Strong Heart Study demonstrated a significant association between microalbuminuria and echocardiographic parameters of LV systolic and diastolic function. The larger Losartan Intervention For Endpoint reduction in hypertension (LIFE) study confirmed this finding (4).
Many researchers have proposed that albuminuria is an integrated marker of structural and functional abnormalities in cardiovascular diseases, such as hypertensive vascular abnormalities, endothelial dysfunction, hypertensive cardiac abnormalities, and impairment of renal function (1).
The pathophysiologic processes that link microalbuminuria and CVD are unclear. Some studies used markers of inflammation which indicate that low-grade inflammation is associated with the occurrence and the progression of microalbuminuria and with an associated increased risk for atherosclerotic disease (5). However, other studies indicate that although microalbuminuria, endothelial dysfunction, and low-grade inflammation are linked, they all are independently associated with risk for cardiovascular death. The inconsistency of these observations may reflect, in part, inadequate precision of the measurements of endothelial function and inflammation. Therefore, based on the evidence we suggest further research to answer actual concerns.

References
1. Ibsen H, Olsen MH, Wachtell K, Borch-Johnsen K, Lindholm LH, Mogensen CE, Dahlöf B, Devereux RB, de Faire U, Fyhrquist F, Julius S, Kjeldsen SE, Lederballe-Pedersen O, Nieminen MS, Omvik P, Oparil S, Wan Y. Reduction in albuminuria translates to reduction in cardiovascular events in hypertensive patients: losartan intervention for endpoint reduction in hypertension study. Hypertension 2005;45(2):198-202.
2. Gerstein HC, Mann JF, Yi Q, et al. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA 2001;286:421-6.
3. Yuyun MF, Khaw KT, Luben R, Welch A, Bingham E, Day NE, Wareham NJ. A prospective study of microalbuminuria and incident coronary heart disease and its prognostic significance in a british population. The EPIC-Norfolk study. Am J Epidemiol 2004;159:284–93.
4. Brenner BM, Cooper ME, de Zeeuw D, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001;345:861-9.
5. Weir MR. Microalbuminuria and Cardiovascular Disease. Clin J Am Soc Nephrol 2007;2:581-90.