Background: This study aimed to evaluate the relationship between the effectiveness of blood pressure (BP) control and telomerase reverse transcriptase concentration (TERT), the concentration of adipose tissue hormones and endothelium function in hypertensive patients., Methods: The study group included 94 people with arterial hypertension. Two subgroups were distinguished according to effective BP control during 24-hour ambulatory blood pressure monitoring (ABPM): Group A - effective BP control (n=49) and Group B - ineffective BP control (n=45). Telomerase reverse transcriptase concentration, blood visfatin concentration and blood adipsin concentration were determined. The function of the endothelium was measured with the flow-mediated dilatation (FMD) method., Results: Telomerase reverse transcriptase concentration, blood visfatin concentration and FMD were higher in Group A compared with Group B. Ineffective BP control was an independent risk factor for lower TERT, lower blood visfatin concentration and lower FMD. Diuretics, β-blockers and angiotensin receptor blockers were independent protective factors for lower TERT. Angiotensin-converting enzyme inhibitors (ACEI) were independent protective factors for lower blood visfatin concentration. Calcium channel blockers were independent protective factors for lower FMD., Conclusions: Ineffective BP control, assessed by ABPM, was associated with decreased TERT, worse metabolic profile of adipose tissue and impaired endothelial function in hypertensives., (Copyright © 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)