The aim of the study was to assess relationship between organ damage and changes of cognitive function in postmenopausal women with arterial hypertension during 3 years of follow-up. A total of 55 women (aged 69+/-9,5 years) with stable course of hypertension were included. During period of observation and treatment cognitive function deteriorated in 40 and improved in 60% of women. Cox regression analysis showed that worsening of cognitive function was associated with low level of education (R 3.85, =0.021), lack of work (R 5.71, =0.035), left ventricular (LV) end-diastolic diameter (R 6.89, =0.019), LV end-systolic diameter (R 3.21, =0.047), left atrium (R 15.20, =0.020), microalbuminuria (R 11.14, =0.041) and duration of chair-rising test (R 7.0, =0.025). Our findings indicate that progressive organ damage, low level of education and lack of work are associated with deterioration of cognitive function and functional mobility in women with hypertension. Our results reinforce the need for early detection of cognitive impairment as a marker of subclinical brain damage to prevent dementia.