title: Accumulation of microvascular target organ damage in newly diagnosed hypertensive patients.
abstract: Early identification of hypertensive target organ damage (TOD) emerges as important for global cardiovascular risk assessment. Retinal vascular alterations, capillary rarefaction, and microalbuminuria represent different forms of microvascular TOD. However, data regarding their concomitant presence in the early stages of hypertension, the association of the number of affected organs with cardiovascular risk, and aldosterone effect on multiple TOD are lacking. We studied naïve, never-treated patients with recent duration of hypertension and healthy volunteers. Innovative software was developed to estimate retinal vascular diameters and capillary density. Biochemical parameters including microalbuminuria and serum aldosterone were derived. Framingham Risk Score was used to determine cardiovascular risk. In total 103 subjects, 66 hypertensives and 37 normotensives, were included. Hypertensive patients exhibited a greater number of affected target organs compared with normotensives (P = .014), with retinopathy and capillary rarefaction (40.9%) representing the most common TOD among hypertensives. The number of affected organs was linearly correlated with increased Framingham score and serum aldosterone, analyzed with univariate (P < .001 and P = .002) and multivariate analysis (P = .025 and P = .004), respectively. Physicians dealing with hypertensive patients should be aware of the possibility of diffuse microvascular impairment and seek multiple TOD even in the early stages of hypertension.
authors.affiliation: 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. Electronic address: artriant@hotmail.com.
authors.forename: Areti
authors.initials: A
authors.lastname: Triantafyllou
authors.affiliation: 2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Anyfanti
authors.affiliation: Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece.
authors.forename: Xenophon
authors.initials: X
authors.lastname: Zabulis
authors.affiliation: 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Gavriilaki
authors.affiliation: Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Crete, Greece.
authors.forename: Polykarpos
authors.initials: P
authors.lastname: Karamaounas
authors.affiliation: 2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Gkaliagkousi
authors.affiliation: 2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Petidis
authors.affiliation: 2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Athina
authors.initials: A
authors.lastname: Pyrpasopoulou
authors.affiliation: 1st Cardiology Division, Onassis Cardiac Surgery Center, Athens, Greece.
authors.forename: Chrysafios
authors.initials: C
authors.lastname: Girasis
authors.affiliation: 2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Spyros
authors.initials: S
authors.lastname: Aslanidis
authors.affiliation: 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Stella
authors.initials: S
authors.lastname: Douma
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D020678:Microscopic Angioscopy; D011379:Prognosis; D012164:Retinal Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D012307:Risk Factors
keywords: Microcirculation; aldosterone; capillaroscopy; retinopathy