Organ damage

It is well accepted that hypertension is a multifactorial disease. Only about 10% of the hypertensive patients have secondary hypertension for which causes, ie, partial coarctation of the renal artery, pheochromacytoma, aldosteronism, hormonal imbalances, etc, are known. The hallmark of hypertension is an abnormally elevated total peripheral resistance. In most patients hypertension produces no serious symptoms particularly in the early phase of the disease. This is why hypertension is called a silent killer. However, prolonged suffering of high arterial blood pressure leads to end organ damage, causing stroke, myocardial infarction, and heart failure, etc. Adequate treatment of hypertension has been proven to decrease the incidence of cardiovascular morbidity and mortaUty and therefore prolong life (176—183). 

Treatment of essential or primary hypertension emphasizes not only the lowering of the elevated blood pressure, but also individualized therapy for each patient, providing each patient with minimized unnecessary side effects. The patient s cardiovascular morbidity and mortaUty should be decreased and end organ damage reversed or reduced (184,185). 

Malignant hypertension is a dangerous condition that develops rapidly and requires immediate medical attention. Fbtients with malignant hypertension experience organ damage as die result of hypertension. Target organs of hypertension include the heart, kidney, and eyes (retinopadiy). 

For more information on biomarkers for renal and hepatic effects of chemicals, see ATSDR/CDC Subcommittee Report on Biomarkers of Organ Damage and Dysfunction (1990) and for information on biomarkers for neurological effects, see OTA (1990). 

ATSDR/CDC. 1990. Summary Report Subcommittee report on biological indicators of organ damage and dysfunction. Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA. 

Severely elevated blood pressure without acute end-organ damage... 

Observe (unless other end-organ damage present)... 

Regardless of the initiating process or processes leading to the development of hypertension, the ultimate goal is to reduce the risk of cardiovascular events and minimize target organ damage. This clearly requires the early identification of risk factors and treatment of patients with hypertension. 

What signs of target organ damage does JT exhibit ... 

The main goal of TTP treatment is to prevent end-organ damage. Nonpharmacologic Therapy... 

Hydroxyurea should be considered in SCD with frequent vaso-occlusive crises, severe symptomatic anemia, repeated history of acute chest syndrome (ACS), or other history of severe vaso-occlusive crisis (VOC) complications.6 The prevention of organ damage or reversal of previous damage has not been shown to occur with chronic use of hydroxyurea. 

SCD treatment and prevention are considered successful when complications are minimized. The major outcome parameters are a decrease in morbidity and mortality, measured by the number of hospitalizations, and the extent of end-organ damage seen over time. SCD is a chronic disease that cannot be cured, except with transplantation. 

Pretreatment with monoclonal anti-TNF antibodies prevents mortality (B23, M32) and organ damage (M16) in experimental sepsis. In clinical studies using anti-TNF antibodies, however, the overall benefit of this treatment showed encouraging but no evident results (L22). Recently, the INTERSEPT study suggests a possible role for anti-TNF antibody as an adjunctive therapy, but with no reduction of mortality (C21). There is no plain cause-effect relation between TNF re-... 

---