Great ECG changes (Frank system) with age were found in normal men. ECG diagnostic criteria valid in Romania were studied by multivariate analyses in men aged 40--60 suffering from hypertension (Hyp) without cardiac congestive failure (CCF), out of which one group with left ventricular hypertrophy (LVH) and another one without it. Echocardiographic studies in normal and hypertensive men past forty, as well as studies in experimental Hyp with LVH and without CCF were carried out. Heart X-ray evaluation is not a functional one. Some non-invasive methods in men do not determine an accurate evaluation of LV performance. The increase of LV muscular mass alone cannot explain the ECG changes in LVH in Hyp without CCF. Two conditional adaptive mechanisms: the liberation of catecholamines from the myocardium storage, induced by the pressure overload stress, and the increase of intracellular Ca++ influx could contribute to the respective ECG changes.

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