TY - JOUR T1 - Hypertension mediated kidney and cardiovascular damage and risk stratification: Redefining concepts JO - Nefrología T2 - AU - Márquez,Diego Francisco AU - Rodríguez-Sánchez,Elena AU - de la Morena,Julián Segura AU - Ruilope,Luis Miguel AU - Ruiz-Hurtado,Gema SN - 02116995 M3 - 10.1016/j.nefro.2021.10.003 DO - 10.1016/j.nefro.2021.10.003 UR - https://www.revistanefrologia.com/es-hypertension-mediated-kidney-cardiovascular-damage-articulo-S0211699521002514 AB - Hypertension mediated organ damage (HMOD) refers to structural or functional changes in arteries or target organs that can be present in long-standing hypertension, but it can be also found in naïve never treated patients. Traditionally, cardiovascular risk is stratified with charts or calculators that tend to underestimate the real cardiovascular risk. The diagnosis of HMOD automatically reclassifies patients to the highest level of cardiovascular risk. Subclinical HMOD can be present already at the diagnosis of hypertension and more than 25% of hypertensives are misclassified with the routine tests recommended by hypertension guidelines. Whether HMOD regression improves cardiovascular outcomes has never been investigated in randomized clinical trials and remains controversial. However, different drugs have been probed with promising results in high cardiovascular risk patients, such as the new antidiabetic or the novel non-steroid mineralocorticoid antagonists. Accordingly, trials have shown that lowering blood pressure reduces cardiovascular events. In this narrative review, we will discuss the role of HMOD in cardiovascular risk stratification, the different types of organ damage, and the evidence available to define whether HMOD can be used as a therapeutic target. ER -