Objective Angiotensin converting enzyme(ACE) is responsible for the generation of angiotensin II, which not only has pressor and mitogenic activities but also exerts effects on left ventricular diastolic performance. We investigate the contribution of insertion/deletion (I/D) genetic polymorphisms at the ACE gene to the development of diastolic functional abnormalities in patients with essential hypertension. Design and Methods We examined M-mode, pulsed wave Doppler, Doppler tissue imaging in 134 essential hypertensive patients. The left ventricular mass and index (LVM and LVMI) of each patient were assessed. We determined the ACE genotype from leukocyte DNA. Results The mean age, systolic and diastolic blood pressure and serum level of the cholesterol did not show any difference among the ACE genotype groups. But, BMI is more larger in II allele than ID or DD allele. The mitral inflow Doppler characteristics(E/A ratio, DT and IVRT) of each genotype groups of the ACE gene did not show any difference. When an ANCOVA was performed, the ACE genotype(p=0.003) and age(p<0.001) exerts a significant effect on E/A ratio. The tissue Doppler characteristics and E/E��� ratio was not different significantly among the ACE genotype groups. The Doppler characteristics of pulmonary venous inflow did not show any difference among the ACE genotype groups. Conclusions The I/D polymorphism of the ACE gene do not influences on echocardiographic left ventricular diastolic indices in patients with essential hypertension in Korea.