Objective: Introduction. Cortisol is a hormone produced by the adrenal glands which can reflects stress and contributes to the development of elevated blood pressure. The aim of our work was to assess the association of increased morning cortisol with normal high blood pressure (BP) and hypertension (HT) in St. Petersburg residents. Design and method: Methods. A epidemiological survey of cardiovascular risk was performed in a multi-step stratified random sample of approximately 1600 participants of Saint = Petersburg in 2012–2013. 1600 participants aged 25–65 years were recruited. All subjects signed informed consent and filled validated questionnaires regarding lifestyle, concomitant disease and medication. Fasting blood sampling was performed according to standard procedures. Office BP was registered by OMRON (Japan) twice on right hand in sitting position with calculation of mean BP. Statistical analysis was performed using SPSS Statistics 20. Results: Results. Data analysis was possible in 1591 participants (566 (35,6%) males and 1025 (64,4%) females). The prevalence of different BP levels varies statistically significantly depending on gender, p less 0,0001. The average level of morning cortisol was significantly higher in males 526.65 [405.05;633.23] vs females 470.90 [362.55;597.25], p less 0,0001. Increased morning cortisol more than 536 nmol/l was significantly more often determined among males 263 (46.8%) comparing with females 371 (36.5%), p less 0,0001. The table 1 shows the prevalence of increased cortisol levels in groups different in BP. According to the binary regression analysis adjusted for sex, age, abdominal obesity the association of cortisol level (morning) > 536 nmol/l with presence of normal high BP (OR 1.48 [1.04;2.11], p = 0.028) and HT (OR 1.59 [1.25;2.05], p less 0.0001) was revealed. Conclusions: Conclusions. Among the residents of St. Petersburg elevated cortisol levels was associated not only with hypertension but also with normal high blood pressure. Men had higher levels of the cortisol which was accompanied by higher prevalence of normal high blood pressure and hypertension compared to women.