Study aim was investigation of blood pressure levels (BP) in spouses and assessment of the role of arterial hypertension (AH) in a spouse as risk factor (RF) of AH in a 17-years prospective study. Primary study based on a random sample of citizens of Tomsk (1546 men and women aged 20-59 years) was carried out in 1988-1991. At repeat study which was carried out in 2002-2005 we obtained data on AH and end points from 81.2% of initial population. Cohort family study comprised 427 family couples. Relative risk (RR) of AM development in men in case of AN of a female spouse was 1.63 (95% confidence interval [CI] 1.14 to 2.33). RR of AM development in a women in this situation was 1.5 (95%CI 1.13 to 1.99). Husband's AH was associated with 5.2% elevation of systolic BP (SBP) (p<0.001), 4.8% elevation of diastolic BP (DBP) (p=0.001) in his wife. AH of a wife was associated with 5.5% elevation of SBP (p<0.001) and 5% elevation of DBP (p=0.003) in a husband. Coefficient of correlation (r) of SBP levels between spouses was 0.09 in age group 20-39 years (p=0.041) and 0.16 in age group 40-59 years (p=0.002). For DBP in age group 20-39 years r=0.14 (p=0.002), in age group 40-59 years r=0.10 (p=0.042). In a prospective study in men and women we found higher SBP when AH was detected in a spouse during follow-up compared with individuals whose BP had been and remained normal (by 5.4%, p=0.015) or those whose BP during this period decreased to normal level (by 17.5%; p=0.006). Detection of new cases of AH in men - spouses of women with AN was higher than in man cohabitants of wives without AH (53.8 and 37.3%, respectively, p=0.028). Thus we found concordance of BP levels in spouses, which was conditioned by marital assortment as well as common environment and way of life.