End- Organ Damage and Cardiovascular Risk Factors
Cardiovascular Risk Factors cause end organ damage. The damage is evident at the arterial tree and in the organs that are perfused by the damaged blood vessels.
Development of end organ damage progresses with time. It is a continuum of progression, from the status of healthy organ to end stage failure of organs like the heart, the kidney the brain etc.
It is important to diagnose end organ damage as soon as possible and at the earliest stage since treatment, both non-pharmacological and pharmacological can rescue the organs from destruction.
What are the Symptoms of End- Organ Damage?
In all cases early stage of End- organ damage is asymptomatic. This causes a major difficulty of early diagnosis and prevention. When End- organ damage is symptomatic, it means that considerable damage to the organ is already present and in most cases, restoration ad integrum will not be possible.
When considerable end organ damage is present the signs and findings will be as found in the affected organ when failed. In the heart signs of angina pectoris, heart failure with pulmonary congestion etc. can be present. In the kidney, signs of renal failure will appear as well as in the brain signs of brain failure or stroke will be seen.
In Which Patients End-Organ Damage Develops?
Patients with Cardiovascular Risk Factors are candidates to develop End- organ damage. These patients should be looked for actively, diagnosed and treated as soon as possible. Ideally, screening of the whole population have to be done. However, since this is timely, and not always possible, high risk populations should be screened as first priority. In priority also, are elderly subjects and patients with concomitant diseases. Lifestyle and genetic factors (family history) are very important and should be screened for actively.
How is End-Organ Damage Diagnosed?
The only way to diagnose End- organ damage is to evaluate the function of the End- organs involved. At start, the condition is asymptomatic and painless. Evaluation of potential End- organs like the heart, the kidney, the brain and the whole vascular system (Carotid, Cerebral, Renal, and peripheral arterial system) is essential.
What are the Treatments for End-Organ Damage?
The most important approach to treat End- organ damage is awareness to the condition and the earliest diagnosis possible.
Generally, treatment and balance of all Cardiovascular Risk Factors is initiated. The treatment includes non-pharmacological and pharmacological interventions. Life-style change is a priority. Interventions in diet, physical activity, body weight, cessation of smoking and alcohol are of utmost importance and pharmacological treatment is of importance. Strict follow up and sequential evaluation of the damaged organ with treatment adjustment are important.
What Kind of Doctors Treat End-Organ Damage?
Specifically, a specialist in a specific field should treat end- organ damage, especially if progressive. However, End- organ damage, especially when at early stage, is and should be treated by physicians from all disciplines. The major bulk of physicians that treat End- organ damage are Family Physicians, and of course, Cardiologists, Nephrologists, Endocrinologists, Neurologists, Specialists in Internal Medicine, Nutritionists and practically physicians in all specialties.