This study was conducted to quantify coronary blood how (CBF) noninvasively according to the fractionation principle and to elucidate the relation between CBF and left ventricular hypertrophy, CBF/cardiac output (CO), estimated on the basis of the ratio of myocardial uptake/total injected dose of thallium-201(% cardiac uptake), was determined in 14 control subjects and 40 patients with essential hypertension, CBF and CBF per 100 g of myocardium (unit CBF) were calculated according to the following formulas: CBF=% cardiac uptakexCO, and unit CBF=(CBF/LVM)x100, where CO and left ventricular mass (LVM) are echocardiographically determined. There was good reproducibility of % cardiac uptake (r=0.983, p < 0.0001), Percent cardiac uptake was greater in hypertensive patients (4.65 +/- 1.44%) than in control subjects (3.64 +/- 0.64%), and there was a positive correlation between % cardiac uptake and LVM. CBF (ml/min) was greater in hypertensive patients (240.7+/-80.5) than in control subjects (194.9+/-36.9), but unit CBF (ml/min/100 g) was less in hypertensive patients (102.2+/-26.7) than in control subjects (150.3+/-30.5). Multiple regression analyses showed that LVM was the most potent independent predictor of resting CBF in hypertension. Our results indicate that CBF, determined by thallium-201 myocardial scintigraphy, increases parallel to the increase in LVM, but unit CBF decreases even in the resting condition in patients with essential hypertension.