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Hypertensive disorder can cause cardiac deformities. Elastic characteristic parameters, like Young’s modulus of elasticity ( E ) derived from a traditional cylindrical model, increase significantly with aging. However, the geometric and component changes of aging hearts because of chronic hypertension remain unknown. To better describe the effects, we propose an elliptical elastic and mathematical model to evaluate myocardial stiffness. Ninety-six hypertensive patients (HTN Pos ) (men: 59.3%; age ≥ 65 years: 20.8%) were enrolled and compared with normotensive controls (HTN Neg ) (n = 47, 48.9%). HTN Pos  patients had a thicker interventricular septum in diastole (IVSd) (HTN Pos : 0.96 ± 0.21 cm vs. HTN Neg : 0.77 ± 0.15;  p  = 0.005) and higher intracardiac pressure (e/e′: 9.06 ± 4.85 cm vs. 7.76 ± 3.41;  p  = 0.01), especially the elderly (&gt; 65 years) (IVSd: 1.03 ± 0.19 cm, e/e′: 11.39 ± 1.99;  p  = 0.006 and 0.01, respectively). Nevertheless, the internal dimension decreased more significantly in the HTN Pos  rather than in the HTN Neg  elderly (5.23 ± 0.46 vs. 4.74 ± 0.69 cm;  p  = 0.02). We found different directions of cardiac remodeling with normotensive and hypertensive loads. Different from the longitudinal and circumferential strain,  E  and Poisson’s ratio ( υ ) are values that directly present the rigidity of myocardium.  E  was significantly higher in the elderly (8011.92 ± 2431.85 vs. 6052.43 ± 3121.50;  p  = 0.02), whereas  υ  was significantly higher in all HTN Pos  patients (0.73 ± 0.12 vs. 0.61 ± 0.07;  p  &lt; 0.001). Because  E  and  υ  reflected the material changes of myocardium in the HTN Pos  elderly, the proposed elliptical mathematical heart model better describes the geometric deformity induced by aging and hypertension.

Interplay of Aging and Hypertension in Cardiac Remodeling: A Mathematical Geometric Model