Assessment of Target Organ Damage in the Evaluation and Follow-Up of Hypertensive Patients: Where Do We Stand?

Authors

  • Gadi Shlomai MD,

    1. Department of Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Israel
    2. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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  • Guido Grassi MD,

    1. Department of Health Sciences, University of Milano-Bicocca, Milan, Italy
    2. IRCCS Multimedica, Sesto San Giovanni, Milan, Italy
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  • Ehud Grossman MD,

    Corresponding author
    1. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
    • Department of Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Israel
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  • Giuseppe Mancia MD

    1. Department of Health Sciences, University of Milano-Bicocca, Milan, Italy
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Address for correspondence: Ehud Grossman, MD, Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, 52621, Israel

E-mail: grosse@post.tau.ac.il

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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