Objective: To assess the state of target organs damage and prevalence of clinical associated conditions in patients with a hypertensive crisis and uncontrolled arterial hypertension. Design and method: The pilot study included 20 patients hospitalized at the National Medical Research Center of Cardiology over the period from September 2019 to September 2021. The all patients had uncontrolled hypertension (BP < 140/90 mmHg while taking antihypertensive drugs). Among them there are 11 men (55%), 9 women (45%) aged 34 to 80 years old (the average age is 60.9 years). The examination was carried out according to the standard examination protocols for patients with hypertension. After the patients had been followed up to 1 year, the damage of target organs (left ventricular hypertrophy, chronic kidney disease, carotid atherosclerosis), as well as the presence of associated clinical conditions (myocardial infarction, stroke, chronic heart failure, aortic aneurysm, retinal haemorrhages) were assessed. Results: 10 patients formed a group with a hypertensive crisis (BP increased > 140/90 mmHg 1 per week), another 10 patients formed a comparison group (BP increased less than 1 per week without pronounced clinical symptoms). The level of LVMI in patients of the study group was 125.5 ± 52.4 g/m2, and in the comparison group was 93.8 ± 16.0 g/m2. Calculated GFR (using the CKD-EPI formula) in the study group was 69.1 ± 18.4 ml/min/1.73 m2, and in the comparison group was 75.9 ± 21.5 ml/min/1.73 m2, carotid atherosclerosis was 44.5 ± 22.8% and 37.5 ± 13.6% respectively. Associated clinical conditions occurred in 43% of patients with a hypertensive crisis, and in the group of patients with uncontrolled hypertension in only 29%. But future randomized control studies are necessary to proof our preliminary results. Conclusions: Patients with hypertensive crisis have more pronounced damage of target organs, as well as the most frequent prevalence of associated clinical conditions.