Abstract: ObjectiveWe investigated the effect of long-term intensive blood pressure （BP） control （＜140/90 mm Hg） regimen on LVH versus routine antihypertensive therapy in hypertensive patients at high or very high risk. MethodsIn the 763 randomized patients, 382 were allocated to intensive BP control（group Ⅰ） and 381 to routine therapy（group R）.Echocardiography was carried out to measure left ventricular mass index（LVMI） at baseline and follow-up in 437 patients.ResultsAt baseline, characteristics of the participants in the 2 groups were similar.In a mean follow-up of 4 years, in group Ⅰ SBP/DBP was decreased to （133.8±6.6/79.7±5.5）mm Hg, significantly lower than in the group R （151.7±12.7/87.7±8.0）mm Hg, P＜0.0001.In patients who had echocardiographic measurement at least once in the whole follow-up period, LVMI decreased from 124.9 to 119.7 g/m 2 （-4.2%, P=0.007） in group Ⅰ（n=270）, whereas LVMI was increased in group R from 131.0 to 136 g/m~2（+4.5%, P=0.05）.Among 233 patients who had LVH at baseline, intensive treatment resulted in decreased in LVMI （n=142, -14.8 g/m~2 , -10.1%, P＜0.0001）, with no change in LVMI in group R（n=91, -2.9 g/m~2, -1.8%, P=0.53, n=91）.204 patients had no LVH at baseline, at the end of the study,LVMI was increased by 5.3 g/m~2 （5.3%, P=0.03） with the incidence of occurrence of LVH being 26.6% in group Ⅰ（n=128） without difference compared with group R of 35.5%（P=0.12）. ConclusionOur study demonstrated that long-term intensive BP control decreased left ventricular mass and led to regression of left ventricular hypertrophy in high risk hypertensive patients.