Background: sFlt-1 is known to be a soluble form of a receptor for vascular endothelial growth factor. However, its biological effects have not been completely understood. We performed this case-control study to evaluate the relationship between sFlt-1 and the risk of coronary artery disease (CAD) in hypertensive patients. Methods: We enrolled 240 hypertensive patients (males: 190, females: 50, mean age: 60 yrs). CAD group was composed of 120 patients who had angiographically proven CAD, whereas control group was composed of age and sex-matched patients without history of CAD. Patients with acute coronary syndrome were excluded. At the time of enrollment, blood was sampled for measurement of sFlt-1. Logistic regression was used to evaluate the relationship between sFlt-1 and risk of CAD. Results: Serum sFlt-1 level was significantly higher in patients with CAD than in patients without CAD (77 짹 20 pg/m vs 68 짹 17, p< 0.005)(Figure). The risk of CAD was associated with diabetes mellitus, smoking, sFlt-1. After adjustment for confounding variables, diabetes mellitus (p< 0.001), higher sFlt-1 (p=0.002) were identified as independent determinants of CAD (Table). Conclusions: In patients with hypertension, higher sFlt-1 was significantly associated with the risk of CAD independent of other risk factors. Further study would be warranted to elucidate the clinical relevance of sFlt-1 elevation in CAD patients.