Determining hypertensive end-organ damage in trials: a review of current methodologies and techniques.
The determination of hypertensive end-organ damage is the most crucial aspect of any long-term hypertension trial. Definition of inclusion criteria and withdrawal rules, and the evaluation of the treatment regimen in light of the cardiovascular prognosis, are all largely dependent on the trialists' abilities to identify vascular lesions and/or functional deteriorations of the major target organs. Although the vascular complications of hypertension tend to be diffuse, some organs and tissues are particularly sensitive: brain, eye fundus, heart, conduit arteries, and kidneys. To achieve a modicum of diagnostic accuracy, trial investigators will have to combine clinical acumen with a selection of ancillary techniques. This article reviews the compromises resulting from weighing the available technological potential against such conflicting factors as convenience and compliance of trial subjects, and expenditure.
Birkenhäger
W H
WH
Erasmus University, Rotterdam, The Netherlands.
de Leeuw
P W
PW
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000209:etiology; D002985:Clinical Protocols; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D007674:Kidney Diseases / Q000209:etiology; D015337:Multicenter Studies as Topic; D012164:Retinal Diseases / Q000209:etiology
D000959:Antihypertensive Agents