Arterial hypertension and cardiac damage: Diagnostic and therapeutic guidelines

Arterial hypertension still represents the most common preventable cause of morbidity and mortality, worldwide, and the WHO states that high blood pressure levels are responsible for 62% of cerebrovascular events and 49% of ischaemic heart diseases globally. Effective antihypertensive treatment significantly reduces individual total cardiovascular risk. Both cardiac and vascular consequences of arterial hypertension derive from structural and functional abnormalities of peripheral arteries, and these clinical conditions strongly predispose to developing major hypertension-related cardiovascular events. Due to the asymptomatic or oligo-symptomatic course, before being clinically evident, of hypertensive cardiopathy (e.g. hypertensive disease), the appropriate and periodic evaluation of structural and functional cardiac damage represents an important diagnostic and prognostic outcome for driving therapeutic strategy in the clinical management of hypertension. The present guidelines, endorsed by the Joint Committee of the Italian Society of Hypertension, the Italian Society of Cardiology, and the Associazione Nazionale Medici Cardiologi Ospedalieri, are aimed to help physicians to choose the best diagnostic and therapeutic approach in the clinical management of any individual hypertensive patient. Received for publication 5 May 2008; accepted for publication 31 August 2008. Key words; hypertension, hypertensive disease, guidelines, organ damage, myocardial infarction, stroke, heart failure, cardiovascular mortality