Estrategia óptima de búsqueda de daño de órgano diana asintomático en hipertenso
- J. Abellán-Huerta 1
- F. Soria-Arcos 1
- L. Prieto-Valiente 2
- L.Consuegra-Sánchez 1
- S. Montoro-García 2
- A.B. Salguero-Merin 3
- R. Morales-López 3
- J. Abellán-Alemán 2
- 1 Hospital General Universitario Santa Lucía, Cartagena, Spain
- 2 Universidad Católica de Murcia, Murcia, Spain
- 3 Centro de Salud Virgen de la Caridad, Cartagena, Murcia, Spain
ISSN: 1889-1837
Year of publication: 2017
Volume: 34
Issue: 4
Pages: 149-156
Type: Article
More publications in: Hipertensión y riesgo vascular
Abstract
Objective To evaluate the diagnostic potential of seven examinations in order to define the most suitable strategy for target organ damage (TOD) search in hypertensive patients. Methods This is a descriptive, cross-sectional study. 153 consecutive treated and essential hypertensive patients were enrolled. Patients with established cardiovascular or chronic renal disease (stage ≥4) were excluded. TOD search was assessed by: glomerular filtration rate (GFR), albumin/creatinine ratio (ACR), electrocardiogram (ECG), echocardiogram (ECO), ankle–brachial index (ABI), pulse wave velocity (PWV), and carotid ultrasound (intima media thickness and presence of plaques). The rationale of our strategy ought to determine the performance of applying a set of the most widely available tests (GFR, ACR, ABI, ECG) and advise about the optimal sequence of the remaining tests. Results The sample was 64.4±7.9 years old, 45.8% males. 82.6% of the sample had any TOD at all. The resulting algorithm found a 37% TOD in relation to GFR, ACR, ABI and ECG values. Adding carotid ultrasound added up to 70% of the studied population and properly classified (TOD+/TOD−) 89% of the cohort. When performing PWV, 78% of the patients had been identified as TOD+ and 96% of the population was correctly identified. Contribution of ECO was minor. Conclusion After running the more widely available explorations (GFR, ACR, ABI, ECG), a step-by-step strategy that included carotid ultrasound, PWV and ECO could be the best sequence for TOD search in asymptomatic hypertensive patients.