Risk assessment tools in hypertensive patients who are likely to develop target organ damage: A narrative mini-review
Dr. Rajiv Karnik, Dr. Avijit Bhattacharya, Dr. Bhupen Desai, Dr. Nitin S Gokhale, Dr. SC Manchanda, Dr. Latchumanadhas K, Dr. AK Kar, Dr. Mohan Bhargava, Dr. Subhash Gupta, Dr. Soumitra Kumar
Background: Hypertension is a major detrimental event in the cardiovascular continuum. Inadequately controlled blood pressure is a driving event for Target Organ Damage (TOD), namely heart, arterial blood vessels, brain, and kidneys. However, vigilance of TOD among hypertensive is imperative. On the basis of this background, we aim to discuss different risk assessment tools in hypertensives who are likely to develop TOD.Methods: We identified relevant full-length articles by electronic databases, namely Medline/PubMed and Google scholar. Studies were searched using key words such as ‘’Risk assessment”, “Framingham Risk Score’’ AND Cardiovascular Disease (CVD), Vascular Age, Stroke, Chronic Kidney Disease.Results: The studies demonstrated that the Framingham Risk Score (FRS) has the potential to predict next 10-year risk of CVD, stroke, and vascular age. Kidney Failure Risk Equation (KFRE) predicts 5-year risk of developing kidney failure. The traditional factors such as increasing age, male gender, high blood pressure, diabetes mellitus, and smoking strongly increase the risk of Atherosclerotic Cardiovascular Disease (ASCVD), stroke, and higher vascular age. In contrast, risk of kidney failure is due to creatinine, eGFR, and Urine Albumin: Creatinine (UACR).Conclusion: Traditional risk factor factors contribute to CVD among hypertensive patients. The Framingham-based assessment tools including 10-year CVD, stroke, and vascular age can stratify the level of risk. These are well-known, most useful, and easy to calculate and can estimate absolute risk of an individual hypertensive who is likely to develop TOD. The KFRE provides excellent discrimination of the risk of End-stage Renal Disease (ESRD). These further assist clinicians in counselling and guiding the patients for timely initiation of pharmacotherapy and thus improve compliance. For hypertension, being a cause for TOD, multiple risk assessment tools are required to maximize the organ protection and should be strongly encouraged in the routine clinical practice.