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Hypertension-Mediated Organ Damages should be Divided into Acute and Chronic
Goran Koracevic1,2, Milovan Stojanovic2,3, Marija Zdravkovic4,5
1Department of Cardiovascular Diseases, University Clinical Center Niš, Serbia.
Insights
Hypertension-mediated organ damages (HMODs) lack consistent classification in medical guidelines. This study highlights the need for clear division between acute and chronic HMODs for better patient care.
Area of Science:
- Cardiology
- Nephrology
- Neurology
Background:
- High blood pressure (BP) leads to hypertension-mediated organ damages (HMODs).
- HMODs can be acute (e.g., intracranial hemorrhage) or chronic (e.g., left ventricular hypertrophy).
- Current medical guidelines show inconsistencies in classifying HMODs.
Purpose of the Study:
- To investigate the comparison between different HMODs.
- To determine if major medical guidelines clearly divide HMODs into acute and chronic forms.
Main Methods:
- Conducted a literature search in SCOPUS for 'acute hypertension-mediated organ damage' and 'acute target organ damage'.
- Analyzed available hypertension guidelines for HMOD classification.
Main Results:
- Significant variations exist in the number and type of chronic HMODs listed across guidelines.
- Some guidelines broadly mention organ damage, while others provide detailed lists.
- The classification and number of specified chronic HMODs differ considerably.
Conclusions:
- Many hypertension guidelines fail to list both acute and chronic HMODs.
- Some guidelines mention only acute or only chronic HMODs.
- Acute and chronic HMODs are often mixed or not explicitly divided in guidelines, indicating a lack of consensus.
Introduction:
High blood pressure (BP) damages various structures. The damaged structures are named hypertension-mediated organ damages (HMODs). Some of HMODs are acute (i.e., intracranial haemorrhage), while the others are chronic (e.g., left ventricular hypertrophy (LVH)). The aim of the paper was to investigate how HMODs compare to each other, and to answer the question of whether HMODs are divided into acute and chronic forms in the major medical publications - guidelines.
Methods:
A search for 'acute hypertension-mediated organ damage' and 'acute target organ damage' was performed in the whole papers in SCOPUS. Moreover, the available guidelines on hypertension are analysed.
Results:
Our results show that the mentioned chronic HMODs differ a lot, both in number and qualitatively, i.e. which HMODs are specified. The difference regarding the number of HMODs listed reflects partially the different approach; some guidelines state organ damage in general, and the other guidelines provide extensive lists.
Discussion:
A substantial number of arterial hypertension (HTN) guidelines do not list both acute and chronic HMODs; several guidelines refer to acute HMODs, and some others to chronic HMODs. In a number of HTN guidelines, acute (e.g., intracranial haemorrhage) and chronic HMODs (such as LVH) were mixed. In the vast majority of guidelines, the acute and chronic HMODs are not directly divided.
Conclusion:
Consensus is clearly missing about the definition and classification of HMODs. Multiple reasons suggest that HMODs should be divided into acute and chronic subgroups. We presented some of the arguments and examples to start with.
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