Organ Damage

Participants with clinically significant fatigue had higher accumulated damage than those with low fatigue. Organ damage was measured using an index of irreversible accumulated damage across 12 organ systems. The left ventricle responds to chronically elevated pressure by thickening its walls, analogous to skeletal muscle hypertrophy under sustained load. At crisis levels above 180/120, sustained high pressure creates mechanical friction that accelerates endothelial damage and atherosclerotic plaque formation. Microvascular damage in kidneys and eyes is often driven by the combination of high pressure and inflammation from hyperglycemia, rather than pressure alone. The kidneys and eyes contain extremely fine capillary networks that are particularly vulnerable to damage from sustained high pressure. Left ventricular hypertrophy produces diastolic dysfunction — the stiffened ventricle cannot fill completely — which is a recognized precursor to heart failure.