Background Left ventricular hypertrophy (LVH) and geometric abnormality are associated with morbidity and mortality of cardiovascular disease and stroke.Hypertension is the major cause of LVH.Yet the prevalence and other risk factors of LVH and geometric abnormality in Chinese hypertensive population are unknown.The objective of this study was to investigate the prevalence and risk factors of LVH and geometric abnormality in community-based Chinese hypertensive population.Methods The study was a community-based cross-sectional study,and comprised 4270 hypertension patients with integrated clinical and echocardiographic data.Left ventricular mass was measured by transthoracic echocardiography.LVH was diagnosed by using the criteria of over 49.2 g/m27 for men and 46.7 g/m2.7 for women.LV geometric patterns (normal,concentric remodeling,concentric or eccentric hypertrophy) were calculated according to LVH and relative wall thickness.Logistic regression model was used to determine the odds ratio (OR) and 95％ confidence intervals (CI) of the risk factors of LVH.Results The prevalence of LVH was 42.7％ in 4270 hypertensive patients,with 37.4％ in males and 45.4％ in females,respectively.The prevalence of concentric remodeling,concentric or eccentric hypertrophy was 24.7％,20.2％,and 22.6％,respectively.In Logistic regression model,female (OR 1.3,95％CI 1,1-1.5,P ＜0.01),age (OR 1.02,95％CI 1.01-1.03,P ＜0.01),body mass index (OR 1.2,95％CI 1.15-1.20,P ＜0.01),systolic blood pressure (OR 1.02,95％CI 1.01-1.03,P ＜0.01),and serum triglyceride (OR 1.10,95％ CI 1.00-1.20,P＜0.01) were risk factors of LVH.Female,age,body mass index,systolic blood pressure and serum triglycedde were also risk factors of left ventricular geometric abnormality.Conclusions The echocardiographic LVH is the major complication of patients with hypertension in rural area of China,especially for women.To effectively treat hypertension,weight loss and control of serum triglyceride may help to prevent LVH in hypertensive population.