Hypertensive heart disease is an end-organ consequence of systemic hypertension. Typically chronic pressure overload from hypertension results in left ventricular hypertrophy. Left ventricular hypertrophy is a powerful independent prognostic factor for cardiovascular morbidity and mortality. Echocardiography provides reliable quantification and information on cardiac function and left ventricular mass. In pathologic hypertrophy due to arterial hypertension, initially is impaired left ventricular diastolic function. With long-standing hypertension, impairment of left ventricular contractility, systolic dysfunction and ventricular dilatation with congestive heart failure can occur. Doppler echocardiography is a fundamental instrument to understand functional damage of heart during arterial hypertension.