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Hypertension mediated kidney and cardiovascular damage and risk stratification: Redefining concepts

Diego Francisco Márquez1, Elena Rodríguez-Sánchez2, Julián Segura de la Morena3

  • 1Unidad de Hipertensión Arterial-Servicio de Clínica Médica, Hospital San Bernardo, Salta, Argentina; Instituto de NefroUrología y Nutrición de Salta, Salta, Argentina.

Nefrologia
|February 15, 2023
PubMed

Insights

Hypertension mediated organ damage (HMOD) significantly impacts cardiovascular risk assessment, often leading to underestimation by traditional methods. Diagnosing HMOD automatically reclassifies patients to the highest risk category, highlighting its critical role in managing hypertension.

Area of Science:

  • Cardiology
  • Nephrology
  • Vascular Biology

Background:

  • Hypertension mediated organ damage (HMOD) involves structural/functional changes in arteries and organs.
  • HMOD can occur in long-standing hypertension and even in treatment-naïve patients.
  • Traditional cardiovascular risk stratification tools often underestimate risk, missing subclinical HMOD in over 25% of hypertensive individuals.

Purpose of the Study:

  • To review the role of HMOD in cardiovascular risk stratification.
  • To discuss various types of organ damage associated with hypertension.
  • To evaluate evidence on HMOD as a therapeutic target.

Main Methods:

  • Narrative review of existing literature.
  • Analysis of studies on cardiovascular risk stratification.
  • Examination of evidence regarding HMOD and therapeutic interventions.

Main Results:

  • HMOD diagnosis automatically reclassifies patients to the highest cardiovascular risk level.
  • Subclinical HMOD is prevalent and often missed by routine screening.
  • The impact of HMOD regression on cardiovascular outcomes remains under investigation.

Conclusions:

  • HMOD is crucial for accurate cardiovascular risk stratification beyond traditional methods.
  • Further research, including randomized trials, is needed to confirm the benefits of HMOD regression.
  • Exploring novel therapeutic targets, like mineralocorticoid antagonists, shows promise for high-risk patients.

Keywords:
Cardiovascular risk stratificationDaño órgano dianaEstratificación riesgo cardiovascularHipertensiónHypertensionTarget organ damage

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