ObjectiveTo assess the ratio of early (E) to late atrial (A) mitral Doppler peak flow velocity (Doppler E/A ratio) before and after adjustment for age in patients with moderate to severe hypertension, in whom left ventricular diastolic dysfunction is an early finding. Mitral flow patterns can be used to assess diastolic filling characteristics, and the Doppler E/A ratio is the parameter most commonly used, although it is known to be strongly age dependent. There are no established normal values for this ratio.DesignRetrospective data analysis.SettingA 2000-bed tertiary-care teaching hospital.PatientsWe studied 190 patients (99 women and 91 men; ages 55 ± 13 years) with moderate to severe hypertension.InterventionsThe ratio of early (E) to late atrial (A) mitral Doppler peak flow velocity was measured. As this ratio depends on age, aZscore was calculated to control for this influence. TheZscore is the standardized normal deviation of the mean, with a normal value of 0 ± 2.Main outcome measuresSensitivities and specificities for detecting an age-dependent reduction in Doppler E/A score (Zscore less than −2) with a non-age-dependent Doppler E/A ratio (less than 1) were calculated.ResultsIn 106 of the patients (56%) the Doppler E/A ratio was less than 1.0. Only nine patients (4.7%) had aZscore less than −2. The sensitivity of the Doppler E/A ratio threshold of 1.0 for detecting aZscore less than −2 was 0.89 and the specificity was 0.46. AZscore less than −2 was found only in patients younger than 45 years.ConclusionsThe Doppler E/A ratio was reduced in a large proportion of our patients. However, after correction for age it was decreased in only 4.7% of these patients. The use of a single Doppler E/A ratio threshold value has a weak diagnostic power to detect age-independent changes in mitral flow patterns.