Background. Mechanical forces of carotid artery (CA) are a strong predictor of cardiovascular events. We sought to determine whether CA strain and stiffness are related with left ventricular (LV) geometry among hypertensive patients. Methods. A total 404 consecutively hypertensive subjects (age, 59 +/- 13) underwent carotid ultrasound and echocardiography. For assessment of mechanical forces, the distensibility, b-stiffness, strain and intima-media thickness (IMT) were calculated. LV mass index (LVMI) and relative wall thickness (RWT) were taken for a measure of LV geometry. Results. When compared with other geometry, concentric hypertrophy showed older age, lower carotid artery strain and distensibility, and higher IMT and b-stiffness (Table). In mutivariate analysis, IMT is independently associated with LV geometry even after adjustment for age and blood pressure. Conclusions. Mechanical forces were significantly different according to LV geometry and showed the worst in concentric hypertrophy. Alteration in mechanical forces could be important mechanism of cardiovascular events in concentric hypertrophy.