OBJECTIVE: To observe the related factors of left ventricular configuration in patients with mild to moderate hypertension, and to evaluate the influence of acupuncture on left ventricular configuration and cardiac function. METHODS: Huoxue Sanfeng acupuncture regime formulated by academician SHI Xue-min was applied to 200 patients with mild to moderate hypertension. The treatment was given once a day, 5 times a week for 3 months. Blood pressure and blood lipid levels were measured before treatment. Before treatment and 3 months after treatment, the echocardiography was used to measured end-diastolic left ventricular diameter (LVIDd), end-diastolic left ventricular posterior wall thickness (LVPWTd), and end-diastolic interventricular septum thickness (IVSTd), ejection fraction (EF), left ventricular mass index (LVMI), etc.; the relevant influencing factors of different left ventricular configurations were analyzed. RESULTS: The patients with mild to moderate hypertension had left ventricular dysplasia (left ventricular remodeling, concentric hypertrophy, eccentric hypertrophy) reached 60%, and compared with the normal configuration group and the left ventricular remodeling group, there were significant differences in nighttime mean pulse pressure, total cholesterol, BMI and waist circumference in the eccentric hypertrophy group (P<0.05). LVMI was associated with nighttime pulse pressure, waist circumference, total cholesterol and BMI (P<0.05). Left ventricular relative wall thickness was associated with total cholesterol, BMI and waist circumference (P<0.05). The diastolic function from normal configuration to left ventricular remodeling, concentric hypertrophy and eccentric hypertrophy gradually decreased, but there were no significant difference (P>0.05). The systolic function in the concentric hypertrophy group and the eccentric hypertrophy group was significantly lower than that in the normal configuration group and the left ventricular remodeling group (P<0.05). There was no significant difference in left ventricular systolic function and diastolic function before and after acupuncture (P>0.05). CONCLUSION: Sixty percents of patients with mild to moderate hypertension have abnormal left ventricular configuration and are associated with total cholesterol, BMI, waist circumference and nighttime mean pulse pressure. Studies have not found that acupuncture can significantly improve the left ventricular configuration and left cardiac function.