Prakash Divya
Maharaja Agrasen Hospital, Department of Medicine, New Delhi, India.
J Family Med Prim Care. 2019 Jun;8(6):2042-2046. doi: 10.4103/jfmpc.jfmpc_231_19.
Hypertension (HTN) is difficult to diagnose since it is asymptomatic. Most of the patients with HTN are unaware of their disease, and hence a large number of these subjects have target organ damage (TOD) on their first arrival at hospital or clinic. Hence, early detection and treatment of TOD determines the cardiovascular prognosis in hypertensive patient and can retard or prevent further damage.
An observational and cross-sectional study was carried out in a tertiary care hospital and clinical profile was collected. Newly detected hypertensive men and women were recruited from outpatient and inpatient departments of medicine based on a set of inclusion and exclusion criteria. The study was carried out over a duration of 18 months from March 2014 to August 2015.
A total of 150 participants were included in the study with a mean age of 51.64 ± 11.64 years. A total of 91 participants had presence of at least one TOD. In our study, retinopathy (20.67%), macroalbuminuria (MA) (44.67%), electrocardiographic left ventricular hypertrophy (LVH) (20.67%), echocardiographic LVH (29.33%), diastolic dysfunction (21.33%), and systolic dysfunction (3.33%) were particularly notable. Grade 3 retinopathy, microalbuminria, and diastolic dysfunction were associated with severity of HTN.
We conclude that a strong relationship exists between HTN and TOD. The evidence for TOD was found to be greater than that expected in newly detected hypertensive patients. Hence, a tight control of blood pressure represents the first step in treating essential HTN, which not only keep the blood pressure under control and further steps to be taken to prevent or retard the onset/progression of TOD.
高血压(HTN)由于无症状而难以诊断。大多数高血压患者未意识到自己的病情,因此大量此类患者在首次到医院或诊所就诊时就已出现靶器官损害(TOD)。因此,TOD的早期检测和治疗决定了高血压患者的心血管预后,并可延缓或预防进一步损害。
在一家三级医疗医院开展了一项观察性横断面研究,并收集了临床资料。根据一系列纳入和排除标准,从内科门诊和住院部招募新确诊的高血压男性和女性。该研究从2014年3月至2015年8月进行了18个月。
共有150名参与者纳入研究,平均年龄为51.64±11.64岁。共有91名参与者存在至少一种TOD。在我们的研究中,视网膜病变(20.67%)、大量白蛋白尿(MA)(44.67%)、心电图左心室肥厚(LVH)(20.67%)、超声心动图LVH(29.33%)、舒张功能障碍(21.33%)和收缩功能障碍(3.33%)尤为显著。3级视网膜病变、微量白蛋白尿和舒张功能障碍与高血压的严重程度相关。
我们得出结论,HTN与TOD之间存在密切关系。在新确诊的高血压患者中,发现TOD的证据比预期的更多。因此,严格控制血压是治疗原发性HTN的第一步,这不仅要控制血压,还需采取进一步措施预防或延缓TOD的发生/进展。