Q: My age is 43. I have been taking Coversyl 2 mg and Zyloric 100 mg for high blood pressure and uric acid problem since 5 years. Last year in the month of November 2004, the doctor advised me to take Coversyl 4 mg one tablet daily and Zyloric 2 tabs daily at Apollo. The recent lipid profile is as follows: Total Cholesterol: 308 mg/dl, Triglycerides: 246 mg/dl, HDL: 37.3 mg/dl, LDL: 221.5 mg/dl, VLDL: 49.2 mg/dl, FBS: 94 mg/dl, Uric acid: 6.8 mg/dl, Creatinine: 1.3 mg/dl, SGOT: 51 U/L, SGPT: 82 U/L, Total protein: 8.0 gm%, Albumin: 4.2%, Glob: 3.8 gm%, Microalbumin: 42 mg/l. Now I am worried about my microalbumin levels. Do I have a kidney problem or will I develop one? How do I get rid of this problem and is it necessary to take any medicines? What should be my diet?

A:Microalbumin in urine is a marker of vascular disease process (involvement of small blood vessels – common in high blood pressure and diabetes). It is best tested and monitored by first morning sample of urine for albumin/gm of creatinine. Normal level of microalbumin is less than 30 mg/gm of creatinine. Drugs like Coversyl are good for reducing microalbumin in the urine but it is important also to target all time blood pressure level of <130/80 mmHg. One could increase Coversyl to twice daily doses or add another blood pressure medicines to achieve the blood pressure target. Your lipid profile also reveals high cholesterol & LDL. You would require medicines to reduce these. Ordinarily statins like ‘atorvastatin’ would be the best, however statins can affect liver functions in a very small percentage of persons. In your case, SGPT is borderline high thus it needs to be looked into before prescribing statins. You will need to reduce fats in your diet and eat salt in moderation. You should also exercise daily – like brisk walking or jogging.