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Target organ damage: how to detect it and how to treat it?

Waeber, Bernarda; de la Sierra, Alejandrob; Ruilope, Luis Mc

doi: 10.1097/01.hjh.0000356767.24507.8d

The early detection of cardiac organ damage in clinical practice is primordial for cardiovascular risk profiling of patients with hypertension. In this respect the determination of microalbuminuria is very appealing because it increasingly appears to be the most cost-effective means to identify cardiovascular and renal complications. Considering the treatment of patients with target organ damage, blockers of the renin–angiotensin system have a key position as they are very effective in regressing left ventricular hypertrophy, lowering urinary albumin excretion and delaying the progression of nephropathy. In high-risk patients with atherosclerosis, the use of a blocker of the renin–angiotensin system is also appealing, and it appears increasingly judicious to combine such a blocker with a calcium antagonist whenever required to control blood pressure.

aDivision of Clinical Pathophysiology, Centre Hospitalier Universitaire de Lausanne et Université de Lausanne, Lausanne, Switzerland

bHypertension Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain

cHypertension Unit, Hospital 12 de Octubre, Madrid, Spain

Correspondence to Bernard Waeber, CHUV, Division de Physiopathologie, MP 14/204, CH-1011 Lausanne, Switzerland Tel: +41 21 314 07 60; fax: +41 21 314 25 18; e-mail:

Conflicts of interest: None.

© 2009 Lippincott Williams & Wilkins, Inc.