Should all patients with hypertension have echocardiography?

The feasibility of echocardiographic determination of left ventricular (LV) mass, as well as the advantages that might be gained in some clinical circ umstances and possible indications are examined in the present review, in r elation to the recent WHO/ISH. The information obtained with echocardiogram s in arterial hypertension is an important contribution to risk stratificat ion on an epidemiological scale. In clinical practice, under the ascertaine d condition of a good reliability, an echocardiogram should be recommended as part of the initial work up when patients meet criteria for not starting therapy (low or mild risk WHO-ISM) or in all circumstances in which decisi on-making might be affected by the echocardiographic result. At present, th ere is not sufficient evidence to extend the indication of echocardiography also to patients for whom antihypertensive management is already necessita ted by identification of high or very high risk status.