Background: Long-standing hypertension causes the hypertensive heart disease characterized with left ventricular hypertrophy (LVH), diastolic dysfunction, coronary artery disease and various arrhythmias. It is a form of end organ damages which were usually thought common in the elderly and increasing its incidence along with aging. But it���s being considered that young hypertensive patients can develop early changes of myocardium and its functions. We compared ventricular geometry and systolic and diastolic functions of young male hypertensive patients with those of age-sex matched normotensive patients, using echocardiographic measurements. Methods: The research was done in Yang-Ju military hospital, South Korea with 110 patients who aged from 19 to 27, underwent echocardiography from April 2009 to March 2011. 54 of them were patients with hypertension (HTN) and the others were patients with normotension (NTN) and no known heart diseases. Results: The average age of the patients was 21.35 year-old. BMI was higher in hypertension group (26.4 kg/m2 vs 22.2 kg/m2, P<0.0001). LVMI (97.70 g/m2 vs 87.93 g/m2, P<0.05), diastolic interventricular septum (IVSd, 9.7mm vs 8.8mm, P<0.0001), diastolic LV posterior wall (LVPWd, 10.4mm vs 9.2mm, P<0.0001), relative wall thickness (RWT, 0.40 vs 0.37, P<0.05), aortic root (AoR, 3.10cm vs 2.88cm, P<0.0001) and left atrium (LA, 3.70cm vs 3.47cm, P<0.05) was increased in hypertensive group. E��� (9.77 vs 11.38, P<0.0001) and E���/A��� (1.45 vs 1.73, P<0.01) were decreased in HTN group while, E/E��� (8.89 vs 7.53, p<0.0001) were increased. The markers for metabolic syndrome such as serum cholesterol, uric acid and calcium were also increased in HTN group. Proteinuria was more common in HTN group. Regression models made of BMI and average systolic blood pressure (aSBP) in ambulatory blood pressure monitoring (ABPM) showed parameters of diastolic functions such as E���, E/E���, E���/A��� were not related with systolic BP but with BMI, while parameters of LV Geometries such as LVMI, RWT, IVSd, LVPWd and AoR were still related with aSBP. LVMI (r=0.441) and IVSd (r=0.561) showed linear correlation with aSBP. RWT showed increase in patient with more than 1 year���s history of HTN (0.41 vs 0.36, p<0.01). Discussions. LVH, associated changes in LV geometry and changes in diastolic functional parameters such as E��� and E/E��� begin to occur in early stage of HTN. Without overt diastolic dysfunction, LV remodeling develops so early stage of HTN that monitoring of developments of myocardial remodeling and control of blood pressure should be more vigorous from early stage of HTN.