CLASSIC PAPERS SYMPOSIUM - HISTORY OF MEDICINE SERIES - SURROGATE INDEXES OF TARGET ORGAN INVOLVEMENT IN HYPERTENSION

This review of previous work provides credence that the fourth heart s ound associated with electrocardiographic evidence of left atrial abno rmality and hyperuricemia is an easily determined and cost-effective c linically determined functional surrogates of hypertensive heart and k idney involvement, respectively, These routinely obtained clinically m easurable indexes are well established and are pathophysiologically re lated to the functional involvement of the heart and kidney from hyper tensive cardiovascular disease. Moreover, these seemingly nonspecific findings provide strong clinical support for feasible means to determi ne the independent risk of hypertensive left ventricular hypertrophy a nd renal involvement in patients with hypertension, In these times of using routine clinical information for cost-effective outcomes, those measurements provide excellent surrogate pathophysiologic indices.