TARGET ORGAN DAMAGE IN ARTERIAL HYPERTENSION

Arterial hypertension is one of the leading risk factors for cardiovascular diseases, and target organ damage significantly worsens patient prognosis. In outpatient practice, early diagnosis of microvascular changes (retinopathy, reduced capillary density, albuminuria) plays a crucial role in assessing the degree of organ damage and determining the optimal treatment strategy. Objective: To study target organ changes in patients with arterial hypertension. Materials and Methods: A retrospective analysis was conducted at City Polyclinic No. 17 in Almaty, involving 157 patients under cardiological follow-up. Patients were categorized into three groups based on disease duration: up to 1 year (n=39, 25%), 1–10 years (n=63, 40%), and more than 10 years (n=55, 35%). The study methods included an assessment of clinical parameters (blood pressure, BMI, heart rate), laboratory tests (eGFR, lipid profile, glucose, HbA1c), and instrumental examinations (ECG, echocardiography, renal artery Doppler ultrasound, ophthalmoscopy). Statistical analysis was performed using Microsoft Excel 2016, applying descriptive statistics and Student’s t-test (M±m) with a significance level of p<0.05. Results: With increasing hypertension duration, BMI increased (p=0.04), and the incidence of left ventricular hypertrophy (up to 81.8%, p<0.001), atrial fibrillation (up to 16.4%, p=0.01), and chronic heart failure (NYHA class III–IV, up to 41.8%, p<0.001) rose. Echocardiographic analysis (n=98) revealed a progressive increase in left ventricular mass index, wall thickness, and left ventricular dilation. Ejection fraction declined by 3.0% in patients with hypertension ≤1 year, by 6.5% in those with hypertension for 1–10 years, and by 8.2% in those with hypertension for over 10 years. Renal function deteriorated, with a significant reduction in eGFR (p<0.001), an increase in chronic kidney disease stage 3 and above (up to 38.2%, p=0.002), and proteinuria prevalence reaching 32.7%. Ophthalmoscopy demonstrated the progression of retinopathy (up to 68.4%, p<0.001). These findings confirm that prolonged hypertension leads to increased target organ damage. Conclusion: Arterial hypertension is a major risk factor for cardiovascular diseases, and target organ damage significantly impacts patient outcomes. Microvascular alterations (retinopathy, albuminuria, reduced capillary density) serve as early indicators of organ damage and require timely diagnosis. Their early detection and correction can slow the progression of complications and improve quality of life. Further research is needed to refine diagnostic and preventive strategies for these disorders.