Department of Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Clin Hypertens (Greenwich). 2013 Oct;15(10):742-7. doi: 10.1111/jch.12185. Epub 2013 Aug 19.
Hypertension is associated with damage to the heart, kidneys, and vascular tree. Assessment of target organ damage (TOD) allows better prediction of cardiovascular risk than conventional risk assessment. Regression of TOD during antihypertensive treatment, which depends on the blood pressure (BP) reduction and the specific ancillary properties of each drug, may indirectly indicate that BP is well controlled. It is unclear whether regression of TOD during treatment is associated with favorable outcome and should be used as a surrogate endpoint. There is evidence that regression of left ventricular hypertrophy and albuminuria are associated with a favorable outcome. However, recent studies cast doubts on this evidence. Thus, assessment of TOD is important to define cardiovascular risk, but, so far, regression of TOD cannot be regarded as a major surrogate therapeutic target. The present paper will provide a critical overview of the data available in the literature.
高血压与心脏、肾脏和血管树损伤有关。对靶器官损伤（TOD）的评估比传统风险评估能更好地预测心血管风险。降压治疗期间 TOD 的消退，取决于血压（BP）的降低和每种药物的特定辅助特性，这可能间接表明血压得到了良好控制。尚不清楚治疗期间 TOD 的消退是否与良好的结果相关，是否应将其作为替代终点。有证据表明左心室肥厚和蛋白尿的消退与良好的结果相关。然而，最近的研究对这一证据提出了质疑。因此，TOD 的评估对于确定心血管风险很重要，但到目前为止，TOD 的消退不能被视为主要的替代治疗目标。本文将对文献中可用的数据进行批判性综述。
