End Organ Damage in Hypertension

In accordance with most major guidelines it is recommended that hypertension be diagnosed when a person’s systolic blood pressure (SBP) in the office or clinic is ≥140 mm Hg and/or their diastolic blood pressure (DBP) is ≥90 mm Hg following repeated examination.

Hypertension is the leading risk factor for morbidity and mortality throughout the world. The early detection and severity of typical end organ damage and secondary diseases are key determinants of cardiovascular prognosis in patients suffering from arterial hypertension.

The classic manifestations of hypertensive end organ damage include the following: vascular and hemorrhagic stroke, retinopathy, coronary heart disease/myocardial infarction and heart failure, proteinuria and renal failure and in the vasculature, atherosclerotic change including the development of stenoses and aneurysms (figure 1).

Available Brand

Doctors Liked to Read More

Abstract

Background

End organ damage in hypertension can be detected early, reflects accurately the hypertensive patient’s overall cardiovascular risk, and should be prevented and treated with antihypertensive treatment.

Method

The author of this article selectively review the relevant literature since 1995, including the German and European guidelines for the diagnosis and treatment of arterial hypertension.

Results

Measurement of the intima-media thickness in the common carotid artery and of the pulse-wave velocity is now recommended for the early diagnosis of hypertensive vasculopathy. Left ventricular hypertrophy, an important component of hypertensive heart disease, can be diagnosed by echocardiography and with the aid of new electrocardiographic indices. Early signs of hypertensive nephropathy, namely albuminuria and a decreased glomerular filtration rate, are prognostically valuable and easy to detect. Cerebrovascular damage, including early microangiopathic changes, is best diagnosed by magnetic resonance imaging. The treatment of end organ damage due to hypertension centers on blood pressure reduction. Blockade of the renin angiotensin-aldosterone system is an essential part of the treatment of early end organ damage.

Conclusion

Hypertensive end organ damage can now be diagnosed early and reversed with specific and aggressive treatment.