This was a retrospective cohort study to assess the effect of hypertension (HTN) among Qatari and Asian patients admitted to the Hamad General Hospital in Qatar with heart failure (HF) and to identify risk factors that contribute to the development of HF in HTN patients in the State of Qatar. A total of 20,856 patients were treated during the 10-year period; 8446 were Qataris and 60% were male. Among the total Qatari patients admitted with HF (n = 2342), 52.4% had HTN. The incidence of HTN was slightly higher in males than in females (50.4 vs. 49.6%; p < 0.001). Significantly more HTN patients had diabetes mellitus (DM) (p < 0.001) and hypercholesterolemia (p < 0.001). There was also a significant difference between Qatari and Asian HTN patients in respect of their age (p < 0.001) and gender (p < 0.001). Qatari hypertensive patients were more likely to have DM (p < 0.001). HTN and DM were the most common risk factors for HE (c) 2005 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.