Organ Damage and Blood Pressure in Untreated and Treated Hypertensives

A large number of studies in experimental animals and man show that angiotensin II, catecholamines and many other substances with cardiovascular and/or metabolic effects can favour alterations of organ function and structure independently on their ability to modify blood pressure (BP). There is, however, also a large body of evidence that these alterations are related to BP levels “per se” both in untreated and treated hypertensive patients. This chapter will offer some examples of this relationship mainly based on past work by the authors. The examples will largely focus on organ damages of more common assessment in clinical practice as well as of a more clear prognostic value, i.e. left ventricular hypertrophy, increased urinary protein excretion or reduction of glomerular filtration rate and carotid intima-media thickening or plaques. However, other types of organ damage will be also mentioned, albeit more briefly.