Objectives: Microalbuminuria and decreased in estimated glomerular filtration rate (eGFR) are risk factors for cardiovascular disease (CVD) in patients with hypertension. However, in hypertensive patients with normal eGFR (���60 mL/min/1.73 m²) and with normo- or microalbuminuria, the value of combined estimation of eGFR and urine microalbumin for the risk assessment has never been reported. We evaluated the association between arterial stiffness and combined estimation of eGFR and urine microalbumin. Methods: Subjects with never treated hypertension and normal eGFR were evaluated (n=496, 305 men, 50짹10 years). Subjects with macroalbuminuria, secondary hypertension, angina pectoris, myocardial infarction, heart failure, stroke, and significant arrhythmia were excluded. eGFR was calculated by the simplified Modification if Diet in Renal Disease formula. Urinary albumin-to-creatinine ratio (UACR) was assessed with spot urine. UACR was log-transformed for analysis (logUACR). Arterial stiffness was assessed with heart-femoral pulse wave velocity (hfPWV). All subjects were divided in four groups; group 1, eGFR ���90 (high normal) and normoalbuminuria; group 2, eGFR 89.9~60 (low normal) and normoalbuminuria; group 3, high normal eGFR and microalbuminuria; group 4, low normal eGFR and microalbuminuria. Results; Group 1 showed lowest hfPWV (964짹145; group 2, 1013짹169; group 3, 1056짹236; group 4, 1060짹164 cm/sec). Analysis adjusting age, sex, body mass index, heart rate and mean arterial pressure showed significantly lower hfPWV of group 1 compared to group 2 (p=0.031) and 3 (p=0.009). Multiple regression analysis showed significant association of hfPWV with logUACR (beta=12.83, 95%CI 2.061~23.603, p=0.02) and eGFR (beta=-0.589, 95%CI -1.178~-0.001, p=0.05). The association was not changed by mutual adjustment with eGFR and logUACR. In patients with normoalbuminuria, eGFR showed significant correlation with hfPWV (beta=-0.787, 95%CI -1.408~-0.165, p=0.013). In patients with high eGFR, logUACR was significantly correlated with hfPWV (beta=22.02, 95%CI 8.850~35.192, p=0.001). Conclusions: The present study showed that the presence of low normal eGFR or microalbuminuria is independently associated with increased arterial stiffness, indicating greater CVD risk. Thus, combined measurement of eGFR and urine microalbumin is needed in the risk assessment of hypertensive patients, although they have normal eGFR or normoalbuminuria.