A comprehensive approach to target organ damage in hypertensive women.
OBJECTIVE
The aim of the present study was to demonstrate how the regression of target organ damage (TOD) in patients with hypertension really improves prognosis. This issue has already been demonstrated in the general population but no data have been provided in postmenopausal women, which represents a particular group of high-risk hypertensive patients.


METHODS
We initially chose to select a number of studies focused on the regression of left ventricular hypertrophy since this plays an extremely important prognostic role and is among the restricted number of risk factors that may be corrected with adequate treatment. We also focused our attention on the issue of endothelial dysfunction, considering that this relatively new pathophysiological entity may represent sensu strictu real organ damage of hypertension that has often been demonstrated in postmenopausal women.


RESULTS
All the reviewed studies agree that the regression of left ventricular hypertrophy is a positive prognostic factor. Moreover, antihypertensive therapy itself is associated with some changes in the degree of endothelial dysfunction. Our preliminary data seem to suggest that the regression of endothelial dysfunction plays a very important prognostic role in terms of event reduction in postmenopausal patients with hypertension.


CONCLUSIONS
Despite a large amount of research remaining to be carried out on the mechanism and the prognostic role of the modifications of TOD in patients with hypertension, the available data demonstrate that the achievement of a reduction in the extent of TOD is extremely important for the evaluation of the efficacy of the treatment in the general hypertensive population, and also in postmenopausal women.
Modena
Maria G
MG
Institute of Cardiology, Department of Internal Medicine, V. del Pozzo 71, 41100 Modena, Italy. modena.mariagrazia@unimo.it
Rossi
Rosario
R
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000503:physiopathology; D004958:Estradiol / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D017698:Postmenopause / Q000187:drug effects / Q000502:physiology; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology; D016387:Women's Health
D000959:Antihypertensive Agents; D004958:Estradiol