Hypertension is one of the principal and modifiable conventional risk factors for cardiovascular disease. There is evidence that hyperhomocysteinemia is also an important independent risk factor for atherosclerosis and thrombotic disease. Assessing the relation ship between hypertension and Hcy, concomitant cardiovascular factors, level of the cofactors important in Hcy metabolism and presence of excessive oxidative stress should be taken into account. Hyperhomocysteinemia promotes hypertension over several mechanisms, including development of endothelial dysfunction and decreased arterial distensibility. Antihypertensive drugs are not similar regarding their effect on Hcy or oxidative stress.