Ventricular remodeling is manifested by an increase in myocardial weight, ventricular volume, and changes in ventricular morphology. Hypertensive left ventricular hypertrophy is the earliest manifestation of cardiac damage and ventricular remodeling, and can progress to heart failure. Myocardial hypertrophy includes hypertrophy of cardiomyocytes and cell proliferation in the myocardial interstitium, an increase in collagen content, and the appearance of interstitial fibrosis. Left ventricular hypertrophy is the main pathological change leading to the development of heart failure in hypertension. The incidence of left ventricular hypertrophy in hypertension is 20-40% and increases with age. Left ventricular hypertrophy can lead to decreased myocardial compliance and filling capacity, diastolic insufficiency, and progressively decreased systolic function, decreased coronary reserve capacity, and arrhythmias. Left ventricular hypertrophy is the strongest independent predictor of cardiovascular events and prognosis in hypertension, with patients with left ventricular hypertrophy having a 2-4 fold increased risk of cardiovascular events. The effects of hypertensive left ventricular hypertrophy on cardiac function include both diastolic and systolic dysfunction, which may be present alone or often together.