Subclinical target organ damage in patients with essential hypertension

Abstract

Assessment of subclinical target organ damage is a key element in the management of patients with hypertension. Impaired diastolic function and increased LV mass are common findings in hypertensive patients and may occur early in the natural history of hypertension. Ultrasonographic measurements of intima-media thickness (IMT) in carotid arteries are being applied extensively and have been regarded as a valid indicator of atherosclerosis. Several studies showed association between IMT and hypertensive target organ damage, cardiovascular events and risk factors. Microalbuminuria is a marker for generalized vascular dysfunction, is the earliest sign of nephropathy and predicts target organ damage, notably renal disease. Hypertensive patients with microalbuminuria had a significantly higher prevalence of CAD, LV hypertrophy, MI and stroke. The modern goal of the treatment of hypertension is to prevent progression, or even to reverse, subclinical target organ damage.