Our patient's target organ damage is reflected by grade II retinopathy and hypertensive cardiac disease characterized by left ventricular hypertrophy and reduced ventricular compliance.

Hypertensive cardiac disease is characterized by left ventricular hypertrophy. Diastolic dysfunction is the earliest and most common manifestation, and is usually asymptomatic. Systolic dysfunction may occur later in the course of the disease. Both systolic and diastolic dysfunction can progress to symptomatic congestive heart failure.

Target organ damage may also involve: the kidneys, and lead to renal failure; the coronary arteries, increasing the risk for myocardial infarction; the peripheral vessels, causing intermittent claudication; and the aorta, causing dissection.

The brain is particularly susceptible to the effects of high blood pressure. Chronic hypertension increases the risk of intracerebral hemorrhage, subarachnoid hemorrhage, ischemic stroke, and vascular dementia. Early subtle changes may include decreased executive and cognitive functions. Rarely, acute hypertension may lead to hypertensive encephalopathy.