Introduction: To evaluate the influence of various parameters of obesity and pulse wave velocity (PWV) in patients with essential arterial hypertension Methods: 142 hypertensive patients (aged 59.7 ± 2.1 years, 67% obese hypertensives, without diabetes) were studied before and aft er 12 months of antihypertensive treatment (ACEI/Amlodipine + Indapamide). Arterial stiffness was assessed by carotidian-femoral pulse wave velocity (Complior method). Obesity was defined using various parameters: body mass index (BMI), waist circumference, waist-to-hip ratio. The results were adjusted for components of cardiovascular risk profile (ANCOVA) and t-test was used for comparative analysis. Results: PWV is related with BMI (t-test) only after adjusting for cardiovascular risk factors (r = -0.217, p = 0.024). The same relation is still significant (p = 0.016) when obesity is graded according to BMI (t-test). PWV strongly relates with waist circumference only in females (p = 0.011), but also in males after multivariate analysis. PWV is independently related to the waist-tohip ratio (r = 0.177, p = 0.045, r2 = 0.031). After 12 months of antihypertensive treatment, PWV is still independently related to the waist-to-hip ratio (r = 0.23, p = 0.02), irrespective the regimen. Conclusions: Our study suggests a complex interrelation between PWV, obesity and antihypertensive regimen. The waist-to-hip ratio independently influences the arterial stiffness in patients with essential arterial hypertension.