Early detection of target organ damage is essential in current clinical practice in order to establish the cardiovascular risk profile of hypertensive patients. Electrocardiogram and echocardiography allow the screening of left ventricular hypertrophy and ischemic heart disease. Atherosclerosis and arteriosclerosis can be searched for non-invasively by ultra-sonographic examination of large arteries, and by measurements of the pulse wave velocity and the ankle-arm index. Much emphasis needs to be put on screening for chronic kidney disease, which can be found at various stages in a majority of hypertensive patients aged 55 and over. Microalbuminuria should not only be regarded as a marker of renal damage, but also as a strong indicator of increased cardiovascular risk.