Systemic hypertension is associated with structural and functional alterations of the coronary circulation, which increase the susceptibility of the hypertensive heart to myocardial ischemia. The spectrum of modifications in the coronary macro and microcirculation of the hypertensive heart is relatively wide, and their assessment requires advanced and possibly non-invasive diagnostic approaches. This paper describes the possibility and the additive value of myocardial contrast echocardiography and of coronary velocimetry by Doppler echocardiography for the assessment of coronary function in hypertensive subjects.