Classic papers symposium: history of medicine series: surrogate indexes of target organ involvement in hypertension.
This review of previous work provides credence that the fourth heart sound associated with electrocardiographic evidence of left atrial abnormality and hyperuricemia is an easily determined and cost-effective clinically determined functional surrogates of hypertensive heart and kidney involvement, respectively. These routinely obtained clinically measurable indexes are well established and are pathophysiologically related to the functional involvement of the heart and kidney from hypertensive cardiovascular disease. Moreover, these seemingly nonspecific findings provide strong clinical support for feasible means to determine the independent risk of hypertensive left ventricular hypertrophy and renal involvement in patients with hypertension. In these times of using routine clinical information for cost-effective outcomes, those measurements provide excellent surrogate pathophysiologic indices.
Alton Oschner Medical Foundation, New Orleans, Louisiana, USA.
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Frohlich
D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D007674:Kidney Diseases / Q000209:etiology*