[Non-invasive methods of evaluation in hypertensive patients]

Major strides have been made, in the past few years, in the field of arterial hypertension, due to the availability of methods permitting a non-invasive, and precise evaluation, outside of the office, of the blood pressure as well as the cardiac response to chronic pressure surcharge. The devices used to record pressure profiles, in an ambulatory situation, are periodically activated, either automatically or by the patient himself. They are portable blood pressure recorders connected to a conventional inflatable arm cuff. The arterial blood pressure thus measured may be quite different from that measured by a physician. The value of the arterial blood pressure recorded in ambulatory is not predictable on the basis of the values obtained in a medical environment. An important factor is that the risk of cardiovascular complication seems to be better correlated to the blood pressure measurements obtained in the usual patient's environment than to those taken by the physician. Sonocardiography is another non-invasive method allowing a better screening of the patients likely to benefit from an antihypertensive treatment. A left ventricular hypertrophy may be detected quite early in an hypertensive patient. The regression of such anomaly under antihypertensive treatment permits to ascertain the good quality of the blood pressure control obtained with antihypertensive medications.