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Resistant hypertension and target organ damage

Maria Lorenza Muiesan1, Massimo Salvetti, Damiano Rizzoni

  • 1Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. muiesan@med.unibs.it

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|April 19, 2013
PubMed

Insights

Resistant hypertension (RH) significantly increases cardiovascular risks and target organ damage (TOD). Effective treatments can control blood pressure and potentially reverse TOD, improving patient outcomes.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Cardiovascular (CV) complications like myocardial infarction, heart failure, stroke, and renal failure correlate with blood pressure (BP) elevation duration and severity.
  • Resistant hypertension (RH) presents a heightened risk for CV complications and target organ damage (TOD).
  • The interplay between CV disease and TOD is bidirectional, with elevated BP in RH causing CV alterations and TOD exacerbating hypertension control difficulties.

Purpose of the Study:

  • To explore the link between resistant hypertension, cardiovascular complications, and target organ damage.
  • To understand the bidirectional relationship between cardiovascular disease and target organ damage in resistant hypertension.
  • To review therapeutic strategies for managing resistant hypertension and its associated target organ damage.

Main Methods:

  • Literature review of studies investigating resistant hypertension, cardiovascular complications, and target organ damage.
  • Analysis of the relationship between elevated blood pressure, structural/functional cardiovascular alterations, and target organ damage.
  • Examination of comorbidities associated with resistant hypertension, such as obesity, sleep apnea, diabetes, metabolic syndrome, and hyperaldosteronism.

Main Results:

  • Resistant hypertension is linked to increased prevalence of target organ damage and higher cardiovascular complication rates.
  • Conditions like obesity, diabetes, and hyperaldosteronism, often co-occurring with RH, involve humoral/hormonal factors contributing to TOD.
  • Elevated BP in RH can lead to left ventricular hypertrophy, aortic stiffness, atherosclerotic plaques, microvascular disease, and renal dysfunction.

Conclusions:

  • Optimal therapeutic strategies, encompassing pharmacological and invasive methods, are crucial for managing resistant hypertension.
  • Achieving adequate blood pressure control can induce regression of target organ damage.
  • Effective management of resistant hypertension and associated target organ damage holds the potential to improve patient prognosis.

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