We compared acoustic quantification (AQ) to Doppler echocardiography (DE) in the evaluation of left ventricular (LV) diastolic filling in 41 hypertensives and 42 controls. In hypertensives, DE showed reduced ratios of early to late diastolic velocity, AQ revealed reduced peak to late filling rate ratios, and both techniques found prolonged acceleration times indicating abnormal filling. In 22 patients with mild hypertension and less LV hypertrophy, however, all DE filling parameters were normal. In these patients AQ indicated prolonged acceleration times and early filling times. In conclusion, AQ is useful for the identification of abnormal LV filling in arterial hypertension and might be superior to DE in detection of early diastolic dysfunction.