Left ventricular (LV) hypertrophy (LVH) confers increased cardiovascular risk on patients with hypertension. Echocardiography using new hand-held devices might allow community-based cost-effective screening for LVH in a targeted hypertensive population. Thus, the aim of this study was to test the validity of hand-held ultrasound devices to screen for LVH in the community. Accordingly, 189 patients with hypertension attending a community-based heart failure screening program underwent echocardiography by both hand-held and standard devices by an experienced echocardiographer. LVH was defined as LV mass index >/=134 g.m(-2) for men and >/=110 g.m(-2) for women using the Devereux-modified American Society of Echocardiography cube equation. No significant differences were noted between the 2 devices in the measurement of LV wall thickness or LV mass index. Agreement for estimation of LVH between the 2 devices was 86% (kappa = 0.63). The sensitivity, specificity, and positive and negative predictive values of the hand-held device for predicting LVH were 72%, 91%, 73%, and 90%, respectively. Thus, hand-held echocardiography devices accurately assessed LVH and may be used for community-based screening for LVH in targeted patients with hypertension.