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Review
. 2013 Oct;15(10):742-7.
doi: 10.1111/jch.12185. Epub 2013 Aug 19.

Assessment of target organ damage in the evaluation and follow-up of hypertensive patients: where do we stand?

Gadi Shlomai  1 , Guido Grassi, Ehud Grossman, Giuseppe Mancia
Affiliations
Review

Assessment of target organ damage in the evaluation and follow-up of hypertensive patients: where do we stand?

Gadi Shlomai et al. J Clin Hypertens (Greenwich). 2013 Oct.

Abstract

Hypertension is associated with damage to the heart, kidneys, and vascular tree. Assessment of target organ damage (TOD) allows better prediction of cardiovascular risk than conventional risk assessment. Regression of TOD during antihypertensive treatment, which depends on the blood pressure (BP) reduction and the specific ancillary properties of each drug, may indirectly indicate that BP is well controlled. It is unclear whether regression of TOD during treatment is associated with favorable outcome and should be used as a surrogate endpoint. There is evidence that regression of left ventricular hypertrophy and albuminuria are associated with a favorable outcome. However, recent studies cast doubts on this evidence. Thus, assessment of TOD is important to define cardiovascular risk, but, so far, regression of TOD cannot be regarded as a major surrogate therapeutic target. The present paper will provide a critical overview of the data available in the literature.

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Figures

Figure 1
Figure 1
Routine and recommended examinations for evaluation of target organ damage (OD) according to European Society of Hypertension/European Society of Cardiology 2007 guidelines. SCr indicates serum creatinine; CrCl, creatinine clearance; GFR, glomerular filtration rate; MA, microalbuminuria; EKG, electrocardiography; LVH, left ventricular hypertrophy; LA, left atrial; CA, carotid artery; PWV, pulse wave velocity.
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