A rterial hypertension is a major risk factor for congestive heart failure. Left ventricular (LV) hypertrophy is often associated with arterial hypertension and characterizes subjects with a particularly elevated risk of untoward cardiovascular events, including heart failure. 1 LV hypertrophy is, in turn, associated with impaired LV myocardial contractility and LV diastolic dysfunction. LV hypertrophy, impaired LV myocardial contractility, and LV diastolic dysfunction predict heart failure in population-based studies. 2,3 Subjects with heart failure but with normal LV ejection fraction, that is, with diastolic heart failure, exhibit abnormal LV diastolic function. 4 However, Doppler parameters of LV diastolic function may be abnormal in the absence of overt heart failure. Such a condition, called "isolated LV diastolic dysfunction," bears independent prognostic significance in population-based and clinical studies. 2,3,5 Thus, regression of isolated LV diastolic dysfunction may be considered an important therapeutic target in hypertension.In the general adult population without congestive heart failure, Ϸ30% may show LV diastolic dysfunction of any degree. 6 In high-risk subgroups (patients Ͼ65 years of age, those with hypertension, and those with LV hypertrophy), the prevalence of isolated LV diastolic dysfunction rises to 60 -80%. 7 On the other hand, LV diastolic dysfunction may be found in Ϸ26% of hypertensive subjects without LV hypertrophy and with normal myocardial contractility. 8 LV hypertrophy regression, proven to be protective in hypertension, 9 is a major determinant of LV diastolic dysfunction regression in hypertensive subjects. 7 However, it remains to be explored whether isolated LV diastolic dysfunction regression would impact independently on cardiovascular prevention in arterial hypertension.In the present issue of Hypertension, Solomon et al 10 focused on isolated LV diastolic dysfunction regression in hypertension using a novel study design. The large majority of the participants in the study by Solomon et al 10 had impaired LV relaxation, which was more prevalent than LV hypertrophy. The study tested the hypothesis that lower in-treatment blood pressure (BP) target could result in greater LV diastolic dysfunction regression. Accordingly, Doppler parameters of LV diastolic function were compared between a regimen defined "intensive," because of a predefined systolic BP (SBP) target of Ͻ130 mm Hg, and a second regimen defined "standard," because of a prespecified SBP target of Ͻ140 mm Hg. Combinations of valsartan, either 160 or 320 mg, plus amlodipine, either 5 or 10 mg, were used; additional antihypertensive medications were added if needed to reach the BP targets. The main finding of the study was that changes in Doppler parameters of LV diastolic function were comparable, on average, between the 2 treatment arms. Hence, on the matter of the impact of aggressive or standard antihypertensive treatment on LV diastolic dysfunction regression, there is apparently no good news.However, the st...