The most investigated novel risk factors of atherosclerosis are: fibrinogen (Fb), homocysteine (Hcy), lipoprotein (a) (Lp(a)), plasminogen activator inhibitor (PAI-1), markers of inflammation and infectious factors. Atherosclerotic renal artery stenosis (RAS) is a manifestation of generalized atherosclerosis and often coexist with hypertension and renal failure. The aim of the study was to assess plasma concentration of Hcy, von Willebrand factor (VWF), (Lp(a), Fb, PAI-1, and assessment of ACE gene polymorphism in pts with RAS and hypertension. The study included 15 patients with RAS (mean age 51.4 +/- 16.5 yrs) and 27 healthy volunteers (C) (mean age 42.9 +/- 9.5 yrs). Plasma concentrations of Hcy were significantly higher in RAS (11.0 +/- 3.9 mumol/L) than in C (6.8 +/- 1.3 mumol/L). Plasma concentration of VWF was also significantly higher in RAS than C (104.7 +/- 40 vs 73.6 +/- 20%) as was FB concentration (325.9 +/- 70.0 vs 256.2 +/- 54.7 mg%). DD genotype was present in 45% of RAS pts and in 12% of controls. In patients with atherosclerotic RAS novel markers of atherosclerosis may be an additional risk factor in the development and progression of atherosclerotic lesions.