[Evaluation of the cardiovascular risk in hypertensive patients: left ventricular hypertrophy].
Left ventricular hypertrophy is associated with a high risk of cardiovascular complications in all the populations in which it has been studied, especially in hypertensive patients. The echocardiographic measurements of left ventricular mass provides a quantitative approach to this risk, independent of the classical cardiovascular risk factors. It is very tempting to wish to replace the measurement of risk factors which, due to their great variability, are not easy to assess (blood pressure) by a marker which integrates several of them (blood pressure, age, weight, salt intake, blood viscosity, serum cholesterol ...) and their variation with respect to time. However, it is too early to recommend this practice for routine use. M mode echocardiographic measurement of left ventricular mass is relatively difficult technique feasible only in about 80% of the population. Even in the hands of experts, its reproducibility is far from perfect. Technical developments may lead to improvement. It remains to be demonstrated that the use of these values improves the management of hypertensive patients and this will not be an easy task. However the follow-up of left ventricular mass during treatment may be an alternative to trials of morbi-mortality in hypertensive patients with the advantage of requiring a shorter follow-up period and fewer patients. It also remains to be demonstrated that regression of left ventricular hypertrophy is accompanied by a corresponding reduction in cardiovascular complications.
Gosse
P
P
Hôpital Saint-André, Bordeaux.
Clémenty
J
J
D000367:Age Factors; D001794:Blood Pressure; D001809:Blood Viscosity; D001835:Body Weight; D002784:Cholesterol / Q000097:blood; D004452:Echocardiography; D005069:Evaluation Studies as Topic; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000517:prevention & control; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000000981:diagnostic imaging / Q000517:prevention & control; D015203:Reproducibility of Results; D012307:Risk Factors; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage
D017673:Sodium Chloride, Dietary; D002784:Cholesterol