Prevention or regression of target organ damage represents today a fundamental objective in the treatment of arterial hypertension. A number of studies performed during the last 20 years have convincingly shown the unfavorable prognostic role of the presence of cardiac vascular and renal structural and functional abnormalities in hypertensive patients. In fact, these alterations are now defined surrogate or intermediate end points. In particular, the presence of left ventricular hypertrophy, and a lesser extent of thickening of arterial walls or microalbuminuria, may be associated with an increase in the number of events. Moreover, regression of target organ disease in hypertension may promote a reduction in cardiovascular events. International guidelines have assessed this concept, suggesting more effective and rapid therapeutic interventions as well as more intensive follow-up programs in hypertensive patients, even with mild elevation of blood pressure levels, who show target organ disease. In the same guidelines the traditional discrimination between primary and secondary prevention has been more properly replaced with an individual stratification of risk in hypertensive patients, based upon the coexistence of other risk factors and/or the presence of target organ damage.
|Journal||Annali Italiani di Medicina Interna, Supplement|
|Publication status||Published - 1999|
ASJC Scopus subject areas
- Clinical Neurology