Hypertension (HTN) is the leading preventable risk factor for cardiovascular disease (CVD) and all-cause mortality worldwide. Despite the implementation of new clinical guidelines and the broad availability of effective pharmaceutical agents, HTN often goes undetected and inadequately treated, shortening life expectancy by five years during adulthood. Long term HTN leads to hypertensive heart disease and is the result of anatomical and functional changes in the cardiovascular system (which is a cardiovascular sequela of HTN) and is defined as left ventricular hypertrophy (LVH), left atrial enlargement, left ventricular diastolic dysfunction, functional mitral regurgitation, and neuro-hormonal changes. Tissue tracking and strain rate imaging are new echocardiography modalities on the basis of Doppler tissue imaging, and they may be used to assess the regional systolic shortening of the LV. Strain rate analysis evaluates whether the regional myocardium is stretching or shortening.