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Arterial hypertension is one of the major risk factor predisposing to atherosclerosis. Since elevated blood pressure is part of endocrine metabolic syndrome, hypertensive patients have many other risk factors predisposing to cardiovascular disease. Early detection of changes accompanying atherosclerosis is of paramount importance, as preventive measures are most successful if taken in the early stage of the disease. The study was focused on changes in arterial walls and in altered blood structure interfering with normal flow of blood. Thickness of the intima and media of the carotid arteries (IMT), and flow-dependent vasodilation and plasma viscosity were determined. IMT was measured by B-mode ultrasound at three different sites, while flow-dependent vasodilation was evaluated by the provocation test performed on the brachial artery. Blood samples were taken for determinations of plasma viscosity and atherogenic factors. We studied 28 hypertensives treated with angiotensin-converting enzyme inhibitors (mean age 55,1 years), and 22 healthy subjects (mean age 54,2 years) with no risk factors for atherosclerosis. In the group of hypertensive patients, the mean IMT determined at all three segments of the carotid artery was significantly greater then in the control group (0,81 ± 0,7 to 0,62 ± 0,07mm, p < 0,0001). Also atherosclerotic lesions were more common in the group of hypertensives. There was a direct relationship between IMT and duration of elevated blood pressure, age, greater waist-hip ratio and increased fasting glucose and triglyceride levels. The presence of atherosclerotic plaque was associated with higher iron and lipoprotein a concentrations. In the hypertensive group, significantly lower flow-dependent vasodilation – which is supposed to be the earliest detectable change occurring in atherogenesis – appeared before the occurrence of morphological changes in the arterial wall. Hypertensive patients had a significantly increased plasma viscosity, which was significantly correlated with IMT of the carotid arteries. In conclusion, our results suggest that regular antihypertensive drug therapy slows the progression of atherosclerosis, but cannot eliminate hemorheological, functional and morphological changes in the arterial wall.