Diagnostic Testing Patterns Influence the Detected Burden of Hypertension‐Mediated Organ Damage in Hospitalized Hypertensive Patients

Hypertension-mediated organ damage (HMOD) plays a central role in cardiovascular risk stratification, yet real-world implementation of guideline-recommended screening remains heterogeneous across Asian healthcare systems. We conducted a retrospective cross-sectional study of 315 hospitalized hypertensive patients admitted to a Vietnamese tertiary referral hospital between January and June 2024 to evaluate completion rates of HMOD-related investigations and the detected burden of organ damage among tested patients. Basic laboratory tests, electrocardiography, and echocardiography were performed in nearly all patients, whereas urine albumin-to-creatinine ratio testing (34.3%), fundoscopic examination (6.7%), and ankle-brachial index measurement (1.6%) were selectively utilized. Left ventricular hypertrophy was detected in 55.9% of the cohort. Among patients undergoing corresponding investigations, diagnostic yield was substantial for peripheral atherosclerosis (70.5%), albuminuria (68.5%), and cerebral white matter lesions (33.0%). Importantly, 68.5% of patients without established cardiovascular disease had evidence of at least one form of HMOD. These findings demonstrate that the apparent burden of HMOD in hospitalized hypertensive patients is strongly shaped by diagnostic testing patterns. Systematic implementation of selected high-yield investigations, particularly quantitative albuminuria assessment, may represent a pragmatic strategy to improve detection of silent organ damage in tertiary-care settings.