Microalbuminuria, usually defined as an urinary albumin excretion(UAE)≥15μg/min,is associated with cardiovascular risk factors and predicts morbid events in non proteinuric essential hypertensive patients (EH). Much less known is the distribution of cardiovascular risk factors in presence of UAE values below the microalbuminuric threshold of 15μg/min. To address that point, we studied 141 never treated, glucose-tolerant male EH with UAE <15 μg/min (the median of three overnight collections). Data were analyzed by evaluating the distribution of 24-hr blood pressure (BP), cardiac structure and geometry (by echocardiography), BMI, common carotid artery intima thickness (IMT, high-sensitivity ultrasonography), insulin sensitivity (as approximated through the HOMA index: fasing insulin (μU/ml)/[22.5 X E-LN(GLUCOSE [MMOL/L])]) (tertile cut-off points: 4.6 and 7.8 μg/min, n=46, 47 and 48 respectively) across UAE tertiles. As compared with the intermediate and bottom thirds, patients in the top tertile showed higher 24-hr BP (143±19/93±12 vs 133±13/86±8 and 135±11/88±10 mmHg, p<0.01), thicker interventricular septum thickness (1.19±0.14 vs 1.1±0.13 and 1.04±0.1 cm, p<0.001), increased relative wall thickness (RWT, IVST+PWT/EDD) (0.47±0.06 vs 0.44±0.06 and 0.44±0.05, p<0.01), heavier body size(26.8±3.1 vs 25.2±2.4 and 25.9±2.2 Kg/m2, p<0.02). Left ventricular mass index (LVMI, 54±14 vs 51±12 and 52±12 g/m2.7) did not differ significantly, but the percentage of patients with a concentric hypertrophic pattern (LVMI> 51g/m2.7 & RWT>0.45) was more frequent in the top tertile (48 vs 18 and 11%, p<0.001). Lipids, carotid thickness (0.73±0.3 vs 0.77±0.2 and 0.75±0.2 mm), HOMA index (2.6±3.8 vs 2.5±1.2 and 2.4±1.1) did not differ. Some cardiovascular and metabolic parameters predictive of risk are linearly associated with UAE values below the conventional microalbuminuric thresholds. Normoalbuminuric EH with high-normal albuminuria are characterized by an adverse risk profile with potentially important negative prognostic consequences. These data might suggest to shift downwards the limits for diagnosing microalbuminuria in essential hypertension, a possibility to be tested in future studies.