Abstract: AIM To analyze the significance of mitral E/A ratio in evaluation of left atrial and left ventricular remodeling in patients of different ages with essential hypertension. METHODS One thousand and eighty-two patients with hypertension (549 males, 533 females) were divided into two groups according to E/A>1 or E/A<1, and the two groups were, respectively, subdivided into young-aged group, middle-aged group and elderly group. Left atrium diameter index (LADi), left ventricular mass index (LVMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure were measured. RESULTS LADi increased with increasing age. In E/A>1 group, LVMI and pulse pressure increased with increasing age, whereas SBP and DBP decreased with increasing age. In E/A<1 group, pulse pressure increased with increasing age, but SBP, DBP and LVMI decreased with increasing age (P<0.05). In the young-age group, E/A ratio, LVMI, SBP and DBP were negatively correlated (r=-0.377, -0.353, -0.226, P<0.05). In the middle-aged group, E/A ratio, SBP and DBP were negatively correlated (r=-0.269, -0.350, P<0.05). In the elderly group, E/A ratio was positively correlated with LADi (r=0.243, P<0.05). CONCLUSION With increasing age, the change of E/A ratio is closely correlated with ventricular remodeling in young and middle-aged patients, and the change of E/A ratio is closely correlated with atrium remodeling in elderly patients.