Impact of hypertension and antihypertensive treatment on organ damage

It is well known that hypertensive patients can greatly reduce their risk of cardiovascular events by controlling their blood pressure at normal levels. However, cardiovascular morbidity and mortality are associated with and preceded by organ damage that can be used as an intermediate endpoint in assessing the benefits of antihypertensive therapy. Contemporary diagnostic techniques—ultrasound, in particular—are making it easier to pinpoint different types of organ damage, and newer antihypertensive agents are demonstrating organ-protective properties independently of their blood-pressure–lowering effects. This article discusses methods of identifying and possibly modifying left ventricular hypertrophy, carotid artery disease, and renal damage, as well as the antihypertensive agents showing organ-protective promise.