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The total cardiovascular risk of hypertensive patients is due to the simultaneous action of risk factors, hypertension-mediated target organ damage or to the presence of established cardiovascular disease. The clustering of cardiovascular risk factors which act simultaneously in patients with hypertension will cause a higher risk than the sum of individual risks due to their multiplicative effect in developing of the atherosclerosis process. This effect is particularly relevant in young patients apparently healthy with a low absolute risk and at who the presence of cardiovascular risk factors in high levels can hide an elevated relative risk of cardiovascular disease which makes as the intensive measures of lifestyle changes to achieve the control of risk factors over time, decreasing the risk of cardiovascular disease. During the years 2017-2018, we performed a retrospective observational study on 280 hypertensive patients, from who 123 patients (43.9%) got established cardiovascular disease called case and the other group called control consists of 157 patients (56.1%) without cardiovascular disease. The study showed that the number of cases with occurred cardiovascular disease has constantly exceeded the number of expected cases after clustering of at least six cardiovascular risk factors upwards, proving that the cardiovascular risk factors do not act individually but synergistically, which what has a multiplicative effect on process of atherosclerosis. [ABSTRACT FROM AUTHOR]