Key result
Hypertension guidelines lack consensus on classifying HMOD into acute versus chronic forms.
Why the study?
The authors sought to investigate how hypertension-mediated organ damages compare to each other and whether major hypertension guidelines divide them into acute and chronic forms.
This review highlights the lack of consensus in current hypertension guidelines regarding the classification of hypertension-mediated organ damage into acute and chronic forms, advocating for such a division.
Clinicians should interpret HMOD listings cautiously given guideline heterogeneity; leaves open whether an acute-chronic split would improve prognostic utility.
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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Koraćević et al. (2025) conducted a review in Hypertension-mediated organ damages (HMODs). Classification of HMODs into acute and chronic was evaluated on Division of HMODs into acute and chronic forms in major medical publications and guidelines. A review of hypertension guidelines revealed a lack of consensus on the definition and classification of hypertension-mediated organ damages, with most not dividing them into acute and chronic subgroups.
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