In this study, we investigated possible relations between left ventricular (LV) concentric remodeling and plasma levels of high-sensitivity C-reactive protein (hs-CRP) and serum amyloid-A (SAA) in subjects who had essential hypertension; 65 consecutive subjects who had hypertension, did not have diabetes, and had normal LV mass were categorized as those whose LV relative wall thickness was <0.44 (n = 41) and those whose relative wall thickness was > or =0.44. Venous blood samples were collected for determination of metabolic profile and plasma levels of hs-CRP and SAA. Subjects whose relative LV wall thickness was > or =0.44 compared with those whose relative LV wall thickness was <0.44 had significantly increased systolic blood pressure by 4.5 mm Hg (p = 0.015) and higher levels of plasma hs-CRP (1.80 vs 1.39 mg/L, p = 0.001) and SAA (10.22 vs 4.86 mg/dl, p = 0.000), although the 2 groups did not differ with regard to age, gender, waist-to-hip ratio, and diastolic blood pressure (p = NS for all). In the entire study population, log hs-CRP and SAA exhibited positive relations with systolic blood pressure (r = 0.21 and r = 0.29, respectively; p <0.05 for the 2 markers) and relative wall thickness (r = 0.26 and r = 0.81, respectively; p <0.05 for the 2 markers). Multiple linear regression analysis showed that age, gender, and diastolic blood pressure were significantly associated with LV mass index (p <0.05), whereas gender, body mass index, log hs-CRP, and SAA were significantly associated with relative wall thickness (p <0.003). By analysis of covariance, log hs-CRP and SAA were significantly different between subjects whose relative LV wall thickness was > or =0.44 and those whose relative LV wall thickness was <0.44 after the adjustment for age, gender, body mass index, and systolic/diastolic blood pressure (p <0.005 for the 2 markers). In conclusion, alterations in LV geometry are associated with increased serum CRP and SAA levels in patients who are newly diagnosed with essential hypertension.