Hypertension remains a pandemic of the 21st century, being a major factor of premature death. The introduction of imaging methods into clinical practice revealed a high prevalence of target organ damage mediated by hypertension. One of the systemic target organs in hypertension is endothelium. Its damage plays an important role in the initiation of the cardiovascular disease continuum. On the other hand, structure and function defects of the endothelium is considered as a possible reason for the increase in blood pressure. This literature review systematizes data on a causal relationship between hypertension and endothelial dysfunction, and discusses the direction of further study of vascular endothelium function. © 2019 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved.