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Left ventricular hypertrophy, diastolic filling abnormalities and systolic dysfunction are well known complications of untreated systemic hypertension. On the other hand, the degree of right ventricular involvement and ventricular interplay in systemic hypertension remains still unclear, though right ventricular hypertrophy, impaired diastolic function and disturbed pulmonary hemodynamics have been reported previously in hypertensive patients. In this article we discuss the possible mechanisms of ventricular interaction in patients with systemic
hypertension. While systolic and diastolic function of the right ventricle is influenced by several factors, including sleep-related breathing disorders, impaired lung function and hypoxia, we present also some problems which are associated with the appropriate assessment of right ventricular function in systemic hypertension.