Abstract BACKGROUND: Treatment of hypertension (HTN) as an important risk factor of coronary artery disease (CAD) is for prevention of its mortality. The aim of the present study was to investigate risk factor distribution, prevalence and severity of CAD among hypertensive and normotensive patients undergoing elective coronary angiography in Tabriz Madani Heart Center. METHODS: In a descriptive cross-sectional study, 976 out of 3000 patients who underwent coronary angiography (CAG) between February 1, 2005 and February 1, 2006 were randomly selected to enter the study. Demographic and angiographic data were collected. Data entry and analysis was done by SPSS software version 11.5 and EPI software version 6.4. RESULTS: Prevalence of hypertension in patients who underwent coronary angiography was 60.5%. Prevalence of CAD was 84% and 87% in hypertensive and normotensive patients, respectively (P = 0.2). Prevalence of diabetes mellitus and hyperlipidemia were more frequent in hypertensive patients (P = 0.001). Although the prevalence of 3-vessel disease was higher in hypertensive patients (32% vs. 28%) the difference was not significant statistically. The difference in prevalence of CAD among hypertensive and normotensive men was not statistically significant (91% and 92%, respectively); but this difference among women was statistically meaningful (78% vs. 63%, p = 0.01). 3-vessel disease in hypertensive women was more frequent than normotensive women (37% vs. 18%, P = 0.02). CONCLUSION: With regard to high prevalence of cardiac risk factors and severe CAD in hypertensive patients, prompt health measures are needed for control of hypertension in general population especially in the hypertensive women. Keywords: Hypertension, Coronary Artery Disease, Risk Factors.