We studied the spontaneous three-year course of «untreated» mild-to-moderate essential hypertension (EH) in 63 patients. Significant increase of blood pressure (ВР) was observed in 49.2 % patients (group 1), no changes of BP – in 38.1 % (group 2), decrease / normalization of BP – in 12.7 % (group 3). The latter group included patients with mild hypertension without damage of target organs. In patients of groups 1 and 2 the development or progression of signs of left ventricular hypertrophy (LVH) was observed. Progression of LVH was accompanied by a trend towards decreased contractile capacity of hypertrophied left ventricular wall, despite preservation of its overall pump function at baseline. This suggests that the preservation of BP level can’t be regarded as lack of progression of the ЕН (even in patients with mild hypertension).