The purpose of this study was to examine left ventricular systolic longitudinal contraction in patients with essential hypertension with normal ejection fraction and fractional shortening. We used tissue tracking and strain rate Doppler echocardiography to evaluate left ventricular longitudinal contraction in 40 patients with hypertension and 30 age-matched control patients. Tissue tracking and peak systolic strain rate were significantly decreased in patients with hypertension and diastolic dysfunction compared with patients with hypertension and normal diastolic function or with control patients. In conclusion, patients with hypertension who, earlier, were considered to have isolated diastolic dysfunction were demonstrated to have reduced left ventricular systolic longitudinal function.