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WOS: 000412463200008, Objective: This study aimed to investigate the relationship between increasing levels of assymetric dimethylarginine (ADMA) and ischemia-modified albumin (IMA) in people with early diagnosis of hypertension (HT) and smoking history. Methods: The study included 95 outpatients who visited our hospital. Patients were classified into three groups: group 1, healthy and non-smokers (n=25); group 2, no smoker patients with newly diagnosed essential HT with LVH (left ventricle hypertrophia) (n=35); group 3, smoking patients with a LVH accompanying newly diagnosed essential HT (n=35). 51% of patients are females; 49% of them are males. The trial was approved by the local ethics committee. Blood samples were analyzed, which were taken after 8 h of fasting. Biochemical parameters such as, C reactive protein (CRP), ADMA, IMA values were recorded. Using echocardiography, cardiac values were recorded. Results: In this study, the first group consisted of 25 patients and second and third group of 35 patients. There were 49 females and 46 males; 70 patients were hypertensive and 6 diabetic. Comparing groups 1 and 2, a significant increase in ADMA was found in group 2. A significant difference was available regarding red cell distribution widht(RDW) and neutrophil lymphocyte ratio (N/L) ratio. Both parameters have increased. Significant differences were found between groups 2 and 3 in terms of ADMA, arginine, albumin, and WBC. While ADMA, white blood cell(WBC), and albumin increased and arginine decreases in group 3. Conclusion: There is an association between ADMA level, smoking, and HT. Patients with HT and smoking history showed increased ADMA level compared with normal. Hypertension and smoking are the causes of increased ADMA, but decreased NO level.