Viazzi Francesca, Leoncini Giovanna, Pontremoli Roberto
Università Degli Studi e I.R.C.C.S. Azienda Ospedaliera Universitaria San Martino-IST, Istituto Nazionale per la Ricerca sul Cancro, 16125 Genoa, Italy.
Int J Hypertens. 2013;2013:542646. doi: 10.1155/2013/542646. Epub 2013 Jul 29.
The knowledge of each patient's global risk profile is a prerequisite for effective therapeutic strategies in primary hypertension. Detecting the presence of subclinical organ damage at the cardiac, vascular, and renal levels is key for stratifying cardiovascular risk and may also be helpful in choosing antihypertensive agents and in monitoring the effectiveness of treatment. A systematic, in-depth search for subclinical organ damage, however, may be difficult to carry out because of logistic and economic problems related to the high prevalence of hypertension in the population. Renal abnormalities such as microalbuminuria and reduction in glomerular filtration rate have proven to be powerful predictors of cardiovascular and renal outcome. Thanks to their relatively low cost and wide applicability, more widespread use of these tests in the diagnostic workup will help detect subsets of patients at greater risk for whom additional preventive and therapeutic treatment is advisable.
了解每位患者的整体风险状况是原发性高血压有效治疗策略的前提。在心脏、血管和肾脏层面检测亚临床器官损害的存在是心血管风险分层的关键，也可能有助于选择抗高血压药物和监测治疗效果。然而，由于与人群中高血压高患病率相关的后勤和经济问题，可能难以对亚临床器官损害进行系统、深入的检查。诸如微量白蛋白尿和肾小球滤过率降低等肾脏异常已被证明是心血管和肾脏预后的有力预测指标。由于这些检测成本相对较低且适用性广泛，在诊断检查中更广泛地使用这些检测将有助于发现那些有更高风险、适合采取额外预防和治疗措施的患者亚组。
