The article is devoted to the modern understanding of endothelial dysfunction development, the role of hyperhomocysteinemia, and, as a consequence, hypertension in patients with multiple myeloma receiving multiagent chemotherapy. Considering that the potential of a standard examination does not allow identifying subclinical endothelial dysfunction, using specific techniques is necessary, in particular, to determine the homocysteine level to monitor the endothelial function.The aim of this review was to summarize the current understanding of hypertension etiology and prospects for detecting early, subclinical endothelial changes, including in patients with multiple myeloma.Assessment of endothelial dysfunction can be useful for detecting precisely the subclinical cardiovascular disease in order to stratify the risk of developing cardiovascular events in patients receiving multiagent chemotherapy.