Objective: To investigate the association between anxiety disorders and left ventricular hypertrophy in patients with essential hypertension. Methods: Left ventricular structure and function were assessed with echocardiography in 56 patients with essential hypertension and anxiety disorder (study group) and in 56 patients with hypertension only (control group). Serum adrenomedullin levels were also measured in these patients. Results: There was no statistically significant difference in the left ventricular ejection fraction between the study and the control group (54.21 +/- 88.81% versus 56.01 +/- 7.85%, p > 0.05). The left ventricular mass index (LVMI) in study group was higher than in control group (137.05 +/- 9.42 versus 123.57 +/- 7.01 g/m(2), p = 0.001). The plasma levels of adrenomedullin in study group was higher than in control group (25.97 +/- 5.48 versus 18.32 +/- 6.97 ng/L, p = 0.001). Levels of plasma adrenomedullin were positively correlated with LVMI in the study (r = 0.734, p < 0.05) and control group (r = 0.592, p < 0.05). Conclusion: Anxiety disorders are associated with elevated plasma adrenomedullin levels and increased left ventricular hypertrophy in patients with essential hypertension. The clinical significance of these changes requires further investigation.