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Cumulative Effects of Several Target Organ Damages in Risk Assessment in Hypertension

Brahim Harbaoui1, Pierre-Yves Courand2, Alice Defforges3

  • 1Cardiology Department, European Society of Hypertension Excellence Center, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France; Université Lyon-1, Villeurbanne, France; Génomique Fonctionnelle de l'Hypertension Artérielle, Lyon, France;

American Journal of Hypertension
|June 27, 2015
PubMed

Insights

Screening for multiple target organ damages (TODs) in hypertension is crucial for predicting patient outcomes. Identifying several TODs significantly increases the risk of both all-cause and cardiovascular mortality, highlighting the need for comprehensive risk assessment.

Area of Science:

  • Cardiology
  • Nephrology
  • Ophthalmology

Background:

  • Prognostic value of multiple target organ damages (TODs) in hypertensive individuals is understudied.
  • This study aimed to assess the prognostic significance of 3 TODs for 10-year survival in hypertensive patients.

Purpose of the Study:

  • To evaluate the prognostic value of multiple target organ damages (TODs) in hypertensive patients.
  • To estimate the impact of TODs on 10-year survival rates.

Main Methods:

  • A cohort of 1,963 hypertensive patients was analyzed.
  • Patients were assessed for previous cardiovascular disease (CVD) and three TODs: renal damage (MDRD <60ml/min or albuminuria >300mg/day), left ventricular hypertrophy (Sokolow index >3.5 mV), and advanced hypertensive retinopathy.
  • The cohort was stratified into groups based on the number of TODs (0, 1, 2, 3) and previous CVD.

Main Results:

  • Over 10 years, 418 deaths occurred, with 254 from cardiovascular causes.
  • A progressive increase in risk was observed with a higher number of TODs.
  • Hazard ratios for all-cause and cardiovascular death significantly increased with each additional TOD, with 3 TODs showing the highest risk.

Conclusions:

  • Hypertensive patients with multiple TODs experience significantly worse outcomes.
  • Screening for multiple TODs, particularly severe retinopathy in patients with left ventricular hypertrophy and renal damage, is essential for risk stratification.
Abstract

Keywords:
blood pressurehypertensionhypertensive retinopathykidneyleft ventricular hypertrophy.

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