Subclinical organ damage and cardiovascular risk prediction

Abstract

Traditional cardiovascular risk factors have poor prognostic value for individuals and screening for subclinical organ damage has been recommended in hypertension in recent guidelines. The aim of this review was to investigate the clinical impact of the additive prognostic information provided by measuring subclinical organ damage. We have (i) reviewed recent studies linking markers of subclinical organ damage in the heart, blood vessels and kidney to cardiovascular risk; (ii) discussed the evidence for improvement in cardiovascular risk prediction using markers of subclinical organ damage; (iii) investigated which and how many markers to measure and (iv) finally discussed whether measuring subclinical organ damage provided benefits beyond risk prediction. In conclusion, more studies and if possible randomized studies are needed to investigate (i) the importance of markers of subclinical organ damage for risk discrimination, calibration and reclassification; and (ii) the economic costs and health benefits associated with measuring markers of subclinical organ damage.

Key Words::

• Cardiovascular risk
• hypertension
• risk stratification
• subclinical organ damage

Acknowledgements

The work of Thomas Sehestedt was supported by a fellowship from the European Society of Hypertension.

Declaration of interest: None declared.