Value of echocardiographic and ambulatory blood pressure monitoring in hypertension

Abstract

This paper reviews the advantages and disadvantages of two new examinations to be employed in hypertension, i.e. echocardiography and ambulatory blood pressure monitoring. It will be emphasized that echocardiography can detect left ventricular hypertrophy in a much more sensitive fashion than electrocardiography thereby allowing a better estimate of the patient's risk of cardiovascular complications. However, this advantage should be considered in the face of the greater cost of this procedure and the inability to obtain reliable echocardiograms in a number of patients. Caution should also be applied in clinical use of ambulatory blood pressure monitoring because of the insufficient data-base on normal ambulatory blood pressure values, the lack of prognostic validation of 24 hour or day-time blood pressure means and the inaccuracy of the automatic blood pressure measuring devices currently available. However, values derived from ambulatory blood pressure monitoring show a better correlation with the target organ damage of hypertension than cuff blood pressure taken in the doctor's office. This justifies the interest in this approach and makes further research on its clinical value worthy.