Key result
Among hypertensive adults, single target organ damage was the most frequent presentation (39.6%), with increased aortic pulse wave velocity being the predominant unique determination (50.6% of these).
Cross-Sectional
In a Romanian hypertensive population, single target organ damage (most commonly arterial stiffness) is the most frequent presentation, indicating that comprehensive assessment of multiple organs is necessary.
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TOD phenotypes show mostly isolated damage with arterial stiffness predominant; leaves open whether multi-organ screening improves risk stratification.
Objective: The aim of our study was to find out the distribution of TOD in hypertensive subjects of SEPHAR III population survey (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk in Romania) in order to define the overlap and specific phenotypes for high blood pressure features of cardiovascular damage. Design and method: Subjects selected on the base of stratified proportional sampling, with age > / = 18 years old and consented to participate in SEPHAR III study have been evaluated for TOD during two study visits, 4 days apart. At visit 1 were measured intima-media thickness (IMT) on the far wall of the common carotid arteries during vascular ultrasound interrogation and pulse wave velocity in the aorta (PWVao) with an oscillometric device. At visit 2 were evaluated indexed left ventricular mass based on transthoracic echocardiography and microalbuminuria. Results: The results are presented in table 1. Table 1. Distribution of target organ damage in hypertensivesThe general distribution of TOD was: increased PWVao - 20%, left ventricular hypertrophy (LVH) - 9.4%, increased carotid IMT - 9%, LVH+increased PWVao - 6,1%, increased IMT + increased PWVao - 5,3%, LVH+increased IMT+increased PWVao - 2,6%, all other variants < / = 2%. In the majority of cases there was only one TOD: 39,6%. In this category, the most frequently encountered determination was increased PWVao (50.6%). In subjects with 2 TOD the main association was of LVH with increased PWVao: 36,2%. In the scenario of 3 TOD, which is rare, the proportion of LVH+increased IMT and increased PWVao was predominant: 82,1%. The association of 4 TOD is negligible. Conclusions: The single organ damage was most frequently encountered, arterial stiffness proving to be the predominant unique determination. Of those with 2 TOD the main association was represented by LVH with increased PWVao, two parameters specifically influenced by arterial hypertension and strongly correlated by pathogenic links. Very few hypertensives have 3 or 4 TOD, therefore there is no TOD that can be used as a substitute for the evaluation of all others.
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Darabont et al. (2018) conducted a cross-sectional in Hypertension. Hypertension was evaluated on Distribution of target organ damage (TOD). Among hypertensive adults, single target organ damage was the most frequent presentation (39.6%), with increased aortic pulse wave velocity being the predominant unique determination (50.6% of these).
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