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<p>Arterial hypertension remains the leading modifiable cause of cardiovascular morbidity and mortality resulting in characteristic changes in cardiac structure and function. Contemporary hypertension clinical guidelines increasingly emphasise prevention and early detection of hypertension-mediated organ damage, yet they differ in how blood pressure is categorised and when further investigation is recommended. Within this prevention-focused landscape and alongside a broader cardio-renal-metabolic framework, this review provides a practical overview on the role of echocardiography in arterial hypertension by integrating contemporary hypertension guidelines with imaging consensus documents. We outline when echocardiography is most likely to add value in hypertension and review echocardiographic assessment of left ventricular structure and geometry, systolic and diastolic function and filling pressures, atrial remodelling, right ventricular assessment, valvular heart disease and the aorta. Practical indications for scanning and transoesophageal echocardiography considerations are discussed. Finally, we highlight future directions including prevention-focused pathways, scalable echocardiography strategies, routine inclusion of contemporaneous blood pressure in reports, artificial intelligence-enabled quantification and selective multimodality imaging within specialist hypertension services.</p>

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Echocardiographic assessment in arterial hypertension: a contemporary narrative review

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月29日

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  • Hafiz Naderi,
  • Kelly Victor,
  • Lynne Williams,
  • Pauline A. Swift,
  • Ian Wilkinson,
  • Sanjeev Bhattacharyya

摘要

Arterial hypertension remains the leading modifiable cause of cardiovascular morbidity and mortality resulting in characteristic changes in cardiac structure and function. Contemporary hypertension clinical guidelines increasingly emphasise prevention and early detection of hypertension-mediated organ damage, yet they differ in how blood pressure is categorised and when further investigation is recommended. Within this prevention-focused landscape and alongside a broader cardio-renal-metabolic framework, this review provides a practical overview on the role of echocardiography in arterial hypertension by integrating contemporary hypertension guidelines with imaging consensus documents. We outline when echocardiography is most likely to add value in hypertension and review echocardiographic assessment of left ventricular structure and geometry, systolic and diastolic function and filling pressures, atrial remodelling, right ventricular assessment, valvular heart disease and the aorta. Practical indications for scanning and transoesophageal echocardiography considerations are discussed. Finally, we highlight future directions including prevention-focused pathways, scalable echocardiography strategies, routine inclusion of contemporaneous blood pressure in reports, artificial intelligence-enabled quantification and selective multimodality imaging within specialist hypertension services.