The article presents the otoneurological characteristics of pre-stroke cerebrovascular disorders in patients with essential hypertension. Among the problems of modern otorhinolaryngology, one of the leading places belongs to cochleovestibular disorders in some cardiovascular diseases, in particular, hypertension. The state of vestibular function in arterial hypertension was studied by many authors who noted a decrease in resistance in such patients. It has been established that one of the reasons for the formation of secondary cochleovestibular disorders is chronic hypertensive encephalopathy, which develops in patients with arterial hypertension, often already in the early stages of the disease. In the study of the peculiarities of the pathogenesis of cochleovestibular disorders, certain results have made it possible to study the nature of the vestibulo-vascular interaction. It is shown, in particular, the difference in vestibulo-vascular reactions in the case of central and peripheral lesions of the vestibular analyzer, which is important for the differential diagnosis of these pathological conditions.