Cardiovascular risk and individualised treatment of hypertension.

Whereas cardiovascular diseases remain a priority amongst preventable disea ses and that their risk factors, especially hypertension, remain inadequate ly controlled, new tools, such as the cardiovascular risk, would allow bett er targeting of treatment on high risk patients. All the evidence is in fav our of prevention based on the estimation of the risk, but this article sum marises the problems which this strategy continues to pose. In particular, necessity of validation at several levels of the equation or equations used (exactitude of the estimated risk, its accuracy and transpo rtability); influence of the mode of presentation of the risk on the percep tion and decision of the physician and patient; practical application of th e strategy; choice of decisional threshold respecting the requirements of d ifferent age groups, and presentation to physicians (recommendations and/or computerisation ?).