Hypertension and target organ damage

The impact of arterial hypertension on the heart, the central nervous system, the arterial vessels and the kidney is responsible for subsequent mortality and morbidity. Evaluation of early target organ damage (TOD) in these organs is an important step in a risk stratification strategy to reduce cardiovascular and renal damage. A panel of TOD was included in the 2013 European Society of Hypertension/European Society of Cardiology (ESH/ESC). Based on availability, cost and clinical significance, the evaluation of left ventricular hypertrophy by electrocardiography and possibly by echocardiography, the measurement of urinary albumin excretion and glomerular filtration rate are the minimal recommended among all TOD. The regression of asymptomatic TOD may occur during antihypertensive treatment, in parallel with the treatment-induced reduction of morbid and fatal cardiovascular (CV) events. Therefore, the evaluation of TOD during treatment may therefore offer valuable information on whether patients are more or less effectively protected by the treatment strategies adopted.