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Coronary artery calcium score >100 Agatston units

Carotid-femoral PWV >10 m/s Brachial-ankle PWV >14 m/s

Plaque (focal wall thickening >1.5 mm)

Cornell voltage: SV3+RaVL>28 mm (men)

SV3+RaVL>20 mm (women)

RaVL ≥11 mm Sokolow–Lyon: SV1+RV5 >35 mm

Cardiac CT

Pulse wave velocity

Carotid or femoral ultrasound

Cardiac biomarkers

Echocardiography

ECG

eGFR ACR Moderate-to-severe kidney disease

LVH

LVH

Diastolic dysfunction

LV mass/height2.7(g/m2.7): >50 (men) >47 (women) LV mass/BSA(g/m2): >115 (men) >95 (women) RWT ≥0.43 LV concentric geometry:

LA volume/height2 (mL/m2): >18.5 (men)

>16.5 (women)

LA volume index (mL/m2): 34 e’ <7cm; E/e’ >14

hs-cTnT or I >99th percentile upper reference limit NT-proBNP >125 pg/mL if age <75 years or >450 pg/mL if ≥75 years

eGFR <60 mL/min/1.73 m2 irrespective of albuminuria Albuminuria ≥30 mg/g irrespective of eGFR

Assistance overcoming patient and physician inertia

Individuals <40 years old with elevated blood pressure

Uncertain situations (i.e. BP or risk close to thresholds, masked or white-coat hypertension, non-traditional CVD risk factors)

Individuals with elevated BP with SCORE2/SCORE2-OP risk of 5–<10%

Support decision to start or intensify BPlowering treatment for:

Why measure? How to diagnose HMOD? What to measure? Which organ?

Kidney

Heart

Arteries

Figure 12 Tests and criteria for defining hypertension-mediated organ damage and considerations for their use in clinical practice. ACR, albumin: creatinine ratio; BP, blood pressure; BSA, body surface area; CT, computed tomography; CVD, cardiovascular disease; ECG, electrocardiogram; eGFR, estimated glomerular filtration rate; HMOD, hypertension-mediated organ damage; hs-cTnT, high-sensitivity cardiac troponin T; LA, left atrial; LV, left ventricular; LVH, left ventricular hypertrophy; NT-proBNP, N-terminal pro-brain natriuretic peptide; PWV, pulse wave velocity; RWT, relative wall thickness; SCORE2, Systematic COronary Risk Evaluation 2; SCORE2-OP, Systematic COronary Risk Evaluation 2–Older Persons. More details and references can be found in the Supplementary data online, Tables S1 and S5.

ESC Guidelines                                                                                                                                                                                          3949

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