Background: Assessment of left ventricular (LV) diastolic function has be reported to be reliable by using Doppler Echocardiography. Several recent studies showed that there was a increased transmitral filling velocity without increased filling pressure just after treadmill exercise in healthy adults. The aim of this study was to evaluate serial changes of diastolic filling patterns during exercise in patients with hypertension and LV hypertrophy. Methods: Supine bicycle exercise was undergone in 10 normal controls (8 men; 30짹8 years old) and 30 patients with hypertension and LV hypertrophy (23 men; 45짹14 years old). Two-dimensional and Doppler echocardiography was performed at the same time with each stage of exercise. Mitral annulus velocity in early (E') and late (A') diastole, peak mitral inflow velocity in early (E) and late (A) diastole, deceleration time of the E-wave velocity, propagation velocity (Vp) were measured. E/Vp, E/E' and E/A were calculated. Exercise stages were reclassified into 4 groups ; baseline, early stage, pre-peak stage and peak stage. Results: In hypertensive group, E and A were increased gradually upto pre-peak stage, but E' and E/E' were increased only upto early exercise stage, after that, there was no significant change. However, in normal control group, E, A, E' and E/E' were increased gradually upto pre-peak stage. Conclusion: In hypertensive patients with LV hypertrophy, there was earlier plateau of change of E' and E/E' than in normal subjects. This suggested that there was different exercise physiology in patients with hypertenison and LV hypertrophy.