Ghrelin is involved in several metabolic and cardiovascular processes. Recent evidence suggests its involvement in blood pressure regulation and hypertension. The aim of the study was to determine associations of single-nucleotide polymorphisms (SNPs) and haplotypes of the ghrelin gene (GHRL) with hypertension and atherosclerotic disease. Six GHRL SNPs (rs27647, rs26802, rs34911341, rs696217, rs4684677 and a -473G/A (with no assigned rsID)) were investigated in a sample of 1143 hypertensive subjects and 1489 controls of Caucasian origin. Both single-locus and haplotype association analyses were performed. In single-locus analyses, only the non-synonymous rs34911341 was associated with hypertension (odds ratio (OR)¼1.95 (95% confidence interval (CI): 1.26-3.02), P¼0.003). Six common haplotypes with frequency 41% were inferred from the studied GHRL SNPs, and their frequency distribution was significantly different between hypertensive subjects and controls (v 2 ¼12.96 with 5 d.f. (degree of freedom), P¼0.024). The effect of rs26802 was found to be significantly (P¼0.017) modulated by other GHRL SNPs, as its C allele conferred either an increased risk (OR¼1.30 (1.08-1.57), P¼0.005) or a decreased risk (OR¼0.50 (0.23-1.06), P¼0.07) of hypertension according to the two different haplotypes on which it can be found. No association of GHRL SNPs or haplotypes with atherosclerotic disease was observed. In conclusion, we observed statistical evidence for association between GHRL SNPs and risk of hypertension.