Hypertension (HT) and Rheumatoid arthritis (RA) associates with accelerated atherosclerosis and high cardiovascular mortality. Cardiovascular risk management in HT pts comorbid with RA is do not fully reflected by traditional risk scales, thus additional factors searching is required. We aimed to estimate the relationship of adiponectin level, insulin resistance with subclinical manifestations of atherosclerosis in HT females comorbid with RA. The study included 82 HT females with comorbid RA (mean age of 54 [50,3; 61,5] years) and 40 RA females without HT (control group). All pts received stable therapy of RA more than 6 months. Рts with coronary artery disease were excluded. The risk of fatal cardiovascular disease was calculated using mSCORE (EULAR 2010). Carotid ultrasound was performed. The levels of adiponectin, insulin were measured using ELISA kit test, insulin resistance was estimated using HOMA2 index. Subclinical manifestations of atherosclerosis were established in 64 (78%) HT females with RA and 20 (50%) control group pts. Mean cardiovascular risk level was 4,52 [3,43; 5,23] %, high and very high cardiovascular risk were estimated in 25 (30,5%) pts. The presence of atherosclerotic plaques in HT females with RA was associated with age (OR = 1,891, p = 0,036, 95% CI 0,89-1,92), RA disease activity (OR = 1,451, p = 0,026, 95% CI 0,97-1,85), LDL cholesterol level (OR = 1,722, p = 0,033, 95% CI 1,04-1,89), insulin resistance (OR = 1,891, p = 0.036, 95% CI 1,09-1,92), increased adiponectin level (OR = 1,645, p = 0,012, 95% CI 1,13-1,84), duration of steroid therapy (OR = 1,543, p = 0,027, 95% CI 1,07-1,85). AUROC index for adiponectin and HOMA2 were 0.78 (95% CI 0.64-0.93; p<0.05) and 0,70 (95% CI 0.5-0.86; p<0.05) respectively, that indicate a good quality of diagnostic models. Cardiovascular risk accessed by modified scale SCORE in hypertensive patients with rheumatoid arthritis do not fully reflects the presence of carotid atherosclerosis. Insulin resistance, adiponectin level determining may be useful additional tools for cardiovascular risk evaluating in this pts.