The renal resistive index (RRI) has been widely shown to be related with subclinical vascular damage in individuals with essential hypertension, as well as in other populations. However, limited data exist regarding the association between RRI and cardiovascular (CV) events in hypertensive individuals. Additionally, it is unclear whether the 10-year risk of CV disease, as predicted by validated score equations, is associated with impaired intrarenal hemodynamics.The aim of our study was to analyze the relationship between RRI and both the FS and ASCVD in hypertensive individuals with no history of CV events.A total of 742 individuals with essential hypertension (40-75 years) were enrolled. RRI was assessed in all patients using Duplex-Doppler ultrasonography, and the 10-year risk of cardiovascular disease was calculated using both the Framingham risk score (FS) and atherosclerotic cardiovascular disease risk score (ASCVD) through validated equations.Higher RRI values were observed in patients with calculated CV risk ≥ 20% compared to those with lower risk (all p 0.67 and >0.65 were associated with a high CV risk (≥ 20%), as calculated through FS and ASCVD equations, respectively.RRI can be considered a marker of overall CV risk in hypertensive patients, independent of renal function.