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Arterial Hypertension and Cardiovascular Risk

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Management of Hypertension

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Abstract

Estimation of total cardiovascular risk is essential for guiding management of hypertension. Computerized methods have been developed for estimating total cardiovascular risk (i.e., the likelihood of developing a cardiovascular event, usually within the next 10 years), most of which are based either on the Framingham risk score or the European SCORE (Systemic Coronary Risk Evaluation) project. The 2013 ESH-ESC guidelines suggest subclinical organ damage as an integral part of the risk stratification and evaluation of hypertensive patients. Subclinical organ damage is considered an intermediate stage in the continuum of vascular disease and a determinant of overall cardiovascular risk. Search for subclinical organ damage should be performed carefully using appropriate techniques depending on the availability and resources. Electrocardiography and evaluation of urinary albumin excretion should be part of routine assessment of hypertensive patients. Subclinical organ damage should be also measured during treatment because there is evidence that regression of left ventricular hypertrophy and reduction of proteinuria are associated with improved prognosis. Search for subclinical organ damage should be made simultaneously in various organs because multiorgan subclinical damage is associated with a worse prognosis.

The current text is an extension and update of the following chapter:

Cífková R. Assessment of Total Cardiovascular Risk in Hypertension: The Role of Subclinical Organ Damage. In: Berbari AE, Mancia G (eds). Special Issues in Hypertension. Springer Milan Heidelberg New York Dordrecht London, pp. 199–212. ISBN 978–88–470-2600-1.

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Authors and Affiliations

  1. Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Prague, Czech Republic

    Renata Cifkova

  2. Department of Medicine II – Cardiology and Angiology, Charles University in Prague, First Faculty of Medicine and General University Hospital, Prague, Czech Republic

    Renata Cifkova

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    Vasilios Papademetriou

  2. Fourth Internal Medicine Department, Evangelismos State General Hospital, Athens, Greece

    Emmanuel A. Andreadis

  3. Fourth Internal Medicine Department, Evangelismos State General Hospital, Athens, Greece

    Charalampia Geladari

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Cifkova, R. (2019). Arterial Hypertension and Cardiovascular Risk. In: Papademetriou, V., Andreadis, E., Geladari, C. (eds) Management of Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-319-92946-0_3

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