Left ventricular diastolic dysfunction (LVDD) is a key element in the clinical syndrome of heart failure with preserved ejection fraction; subclinical LVDD is a predictor of incident overt heart failure. LVDD is associated with cardiometabolic risk factors including hypertension, obesity, diabetes mellitus, and metabolic syndrome, which are known to have a high prevalence in the Mexican American population. Our aim was to study the prevalence of subclinical LVDD and its association with metabolic and clinical correlates in this population at risk.Methods: Demographic, anthropometric, and laboratory data were obtained from an asymptomatic population-based sample drawn from the Cameron County Hispanic Cohort in Texas (n=488). Transthoracic echocardiography was performed and diastolic parameters were evaluated using the 2016 recommendations of the American Society of Echocardiography. Multivariable weighted logistic regression analyses were conducted to evaluate associations between LVDD and clinical and metabolic correlates.Results: Mean age was 51 ± 1 years (57% females). There was a high prevalence of overweight and obesity (83.6%; mean BMI 30.6 ± 0.4 kg/m), hypertension (49.3%), diabetes (29.1%), and metabolic syndrome (58.6%). LVDD was seen in 21.5% of this asymptomatic cohort. After adjusting for age, gender, and BMI, subjects with LVDD had higher systolic BP and diastolic BP (p<0.01), and were more likely to have hypertension, low HDL cholesterol, and metabolic syndrome (p<0.05). Subjects with metabolic syndrome had higher relative wall thickness (p<0.01) and E/e’ suggestive of increased mean left atrial pressures (p=0.02) regardless of BMI. After controlling for age, gender, and all the components of the metabolic syndrome, only hypertension remained independently associated with LVDD (OR=3.879; 95% CI 1.909-7.882).Conclusion: LVDD is highly prevalent among Mexican Americans, and is significantly associated with hypertension and the metabolic syndrome. Cardiac structural and functional abnormalities are already evident in this asymptomatic cohort. Targeted interventions to improve metabolic risk factors, with BP control in particular, may help prevent early cardiac structural abnormalities in this high risk group.