CARDIOVASCULAR RISK AND BLOOD-PRESSURE MEASUREMENTS

Clinical measurement of the blood pressure associated with assessment of the other cardiovascular risk factors : cholesterol, smoking, age, sex, diabetes and cardiovascular heredity, allow appreciation of the c ardiovascular risk of hypertensive patients after the results of the F ramingham study. There is no consensus about the optimal clinical broo d pressure with treatment and about the control of treated hypertensiv es which remains low in population studies (28 % in France, 27 % in th e United States). New methods of blood pressure measurements such as a mbulatory blood pressure monitoring and self-measurement of the blood pressure are better correlated to cardiovascular events and morbi-mort ality than measurement of the blood pressure during consultation in hy pertensive patients. Ambulatory blood pressure recording also seems to be more predictive of regression of left Ventricular hypertrophy. The refore, the Latest recommendations, especially the American consensus, advise using these techniques when the physician is in doubt about th e value of the clinical blood pressure measurement of hypertensive pat ients, especially in the case of apparent antihypertensive drug resist ance. Finally, what does good blood pressure control imply in 1998 : n ormal clinical blood pressure measurements compared with ambulatory bl ood pressure monitoring or self-measurement of the blood pressure ? Do es it mean control of the patient's absolute cardiovascular risk ? The answers to these questions can only be obtained by future prospective studies.