End organ damage

Evidence of hypertensive damage

• Heart - evidence on electrocardiogram screening of the heart muscle thickening up or by echocardiography of less efficient function.
• Brain-Also you can see hypertensive Encephalopathy, CVA hemorrhagic stroke,Subarcnid hemorrhage, confusion, Loss of consciousness, Eclampsia,Seizures and Transient is ischemic attack.
• Kidney - the presence of leakage of protein into the urine, or reduced renal function. you can see Hypertensive nephropathy,Acut renal failure, glomerulonephritis and proteinuria.
• Eye - evidence upon fundoscopic examination of hypertensive retinopathy. Retinal hemorrhage, retinal papilledema and blindness.
• Peripheral Arteries- Peripheral vascular disease and chronic lower limb ischemia.

  Evidence of shock (poor end organ perfusion)

• Kidney - poor urine output, low GFR.
• Skin - pallor or mottled appearance, capillary refill > 2secs, cool peripheries.
• Brain - orientation to time, person, and place. The GCS may be used to quantify altered consciousness if this is present.