Cardiac function of hypertensive patients is normal, or even better than normal, despite the presence of cardiac hypertrophy. It is therefore difficult to explain the mechanism of decompensation phenomena, especially as clinicians are rarely able to observe the passage from the compensated phase to the phase of decompensated hypertensive heart failure. Various arguments suggest that cardiovascular ageing, independently of hypertension, exerts specific haemodynamic effects which can be responsible for decompensation. In the heart, extension of fibrosis can be responsible for a defect of diastolic expansion and the development of arrhythmias. In the vessels, increased aortic rigidity is responsible for a dissociation between cardiac and vascular functions, especially as the pressure reflection wave returns during the systolic phase rather than the diastolic phase of the pressure curve. These data suggest that Cardiac failure phenomena now justify thorough evaluation of arterial function, which can currently be investigated by noninvasive techniques.