Former guidelines on hypertension never made a commitment to the detection of microalbuminuria for screening or follow-up of hypertensive patients. On the other hand, growing evidence support the contributory role of microalbuminuria in the prediction of absolute cardiovascular risk in hypertension and document the potential relevance of this parameter to the initial choice of antihypertensive treatment. Upcoming new guidelines and diagnostic algorithms in hypertension need to underscore the clinical positioning of microalbuminuria for stratification of risk and follow-up purposes.