Ultrasonic techniques for the evaluation of hypertension.
Echocardiography and arterial ultrasound provide "windows" through which the structure and function of the heart and arterial tree can be evaluated noninvasively. M-mode, two-dimensional, and Doppler echocardiographic techniques have been well validated and can measure left ventricular (LV) mass, define LV geometric patterns, and assess systolic and diastolic LV performances. Numerous long-term studies document that echocardiographic detection of LV hypertrophy or concentric remodeling identifies patients with hypertension at a two- to fourfold increased risk of myocardial infarction, stroke, or death. Similarly, well-validated ultrasonic methods can measure the lumen size, wall thickness, presence of atheroma, and aspects of function of the carotid artery and other systemic arteries. Increased arterial wall thickness and discrete atherosclerotic plaques also identify individuals at high risk. Meticulous attention to echocardiographic technique is needed to derive the full benefit for patient management of noninvasive characterization of the heart.