The long existence of arterial hypertension in combination with insulin resistance inevitably impairs the functioning of all elements of hemostasis. In these circumstances, there is a weakening of the vascular control of platelet aggregation, hemocoagulation and fibrinolysis. This is based on the decreased production in the blood vessels of substances with thromboresistant properties, increasing the permeability of the endothelium to macromolecules, accumulation in the vascular wall lipoproteins, adhesion of platelets and leukocytes. For patients with hypertension and insulin resistance characteristic of platelet activation, leading to increased circulating blood platelets with a modified surface structure and their aggregates. It caused such patients, high content in platelets of biologically active substances and the increase in the number of different receptors on their surface, including fibrinogen. The combination of hypertension with insulin resistance inevitably impairs the functioning and coagulation component of hemostasis in the blood increases the content of fibrinogen, VII, VIII, IX coagulation factors, von Willebrand factor by lowering the activity of antithrombin III, protein C and protein S.