Eur J Prev Cardiol. 2026 Jan 28:zwag052. doi: 10.1093/eurjpc/zwag052. Online ahead of print.
ABSTRACT
BACKGROUND AND AIM: Susceptibility to hypertension-mediated organ damage (HMOD) is influenced by genetics, age, gender, and additional cardiovascular risk factors and comorbidities in the individual patient. All major hypertension guidelines recommend assessment of HMOD to identify high cardiovascular risk. However, in clinical practice it may be difficult to choose the optimal strategy and diagnostic tools in the individual patient.
METHODS: We reviewed recommendation on HMOD assessment in the 2024 European Society of Cardiology, the 2023 European Society of Hypertension, the 2025 American Heart Association/American College of Cardiology and the 2020 International Society of Hypertension guidelines to provide an expert opinion on how to optimize diagnosis of HMOD in clinical practice.
RESULTS: Basic assessment of cardiac and renal HMOD is recommended in all patients using electrocardiography, serum creatinine and estimated glomerular filtration rate, and albumin-creatinine ratio in a morning spot-urine. Advanced tests for HMOD assessment are indicated depending on findings at the initial clinical assessment, whether results are likely to change management, and local availability and resources. Echocardiography remains the preferred initial test and may add prognostic information in most patients. Identification of premature atherosclerosis by ultrasound or coronary artery calcium score or arterial stiffness by pulse wave velocity may be indicated in young and middle-aged individuals with arterial hypertension or blood pressure close to treatment threshold if likely to change management.
CONCLUSION: HMOD is a marker of high cardiovascular risk. Basic assessment should be performed in all patients with arterial hypertension, and more advanced tests in selected patients.
PMID:41603527 | DOI:10.1093/eurjpc/zwag052