Objective Assessment of myocardial work in elderly hypertensive patients with different left ventricular configuration using Left ventricular pressure-strain loop. Methods From May 2019 to March 2020, 162 elderly hypertensive patients and 35 healthy elderly patients were selected as the control group for the study. Hypertensive patients were divided into 4 groups according to left ventricular geometry configuration, normal configuration group (42 cases), centripetal remodeling group (40 cases), centrifugal hypertrophy group (38 cases) and centrifugal hypertrophy group (42 cases). All echocardiograms were performed and Echo PAC software to obtain strain, and inputting pressure to construct LV pressure-strain loops to obtain myocardial work parameters. Myocardial work parameters were compared . Results Compared with the control group, the GLS of the hypertension NG group and the CR group had no significant difference (P>0.05), but the GLS of the EH group and the CH group was lower than that of the control group, the difference was statistically significant (P<0.05). The GWI, GCW, and GWW of each hypertension group were higher than those of the control group, and the GWI and GCW of the NG group were significantly greater than those of the control group, the difference was statistically significant (P<0.05). Compared with the control group, the GWE of the hypertensive NG group, CR group, and EH group did not change significantly, while the GWE of the CH group decreased, the difference was statistically significant(P<0.05). Conclusion LVPSL can evaluate the myocardial work of subjects with different left ventricular configurations, and evaluate left ventricular systolic function in hypertensive patients more accurately and comprehensively, providing a basis for early clinical diagnosis and prognosis judgment.