Essential Hypertension – Damage of Target Organs and Significance of Early Detection

Epidemiological data shows that hypertension is the most frequent cardiovascular disease in western countries. The prevalence of disease in Slovenia at the ages of 25-64 years is between 40-50%. Etiopathogenesis of essential hypertension, the most frequent form of hyperten­sion is not well understood. In accordance with the microcirculation theory functional and morphological changes in small resistance vessels is thought to be the cause and consequence of the disease. The important role of this condition is played by abnormal endothelial cel­lular function, which is characterized by decreased production of nitric oxide and unbalanced production of other different vasoactive substances. Essential hypertension is also accom­panied by lipid and glucose metabolic abnormalities (metabolic syndrome), changes in prothrombotic state and haemorheology and by low grade inflammation. The target organ damage in the conduit arteries (atherosclerosis), heart (left ventricular hypertrophy, dias­tolic dysfunction, reduction of coronary reserve) and kidney (nephrosclerosis) are the consequence of the elevated blood pressure. There is currently no effective treatment known for hypertension. This is why it is important to detect it in its early stages, when preventive measures are most effective. Today, with help of non-invasive investigation methods which are mostly mostly ultrasound based, we can detect abnormalities in different organs that pre­dict the unfavourable course of hypertensive disease.