The aim of the study was to evaluate cardiac rhythm variability (CRV) during active orthostatic test (AOT) in patients with arterial hypertension (AH) living in Tyumen near-Ob region. Fifty-two patients with AH and 32 practically healthy persons were examined. Under outpatient conditions in the city of Pyt-Yakh, 5-min CRV recording was performed by standard technique in the supine position and during AOT, and temporary and spectral parameters were evaluated. In both groups, parameters of the temporary analysis of CRV during AOT differed significantly. The values of optimal variability in AH patients displayed significant deviations, while the deviations in the control group were moderate. Analysis of spectral parameters of CRV during AOT revealed an increase in the values of total spectrum power of CRV in both groups. The values of optimal CRV parameters evidenced the presence of disbalance in the vegetative regulation of cardiac rhythm in the subjects. The results of temporary analysis found a lowered activity of parasympathetic vegetative regulation, while spectral analysis revealed an increased sympathetic influence on cardiac rhythm. The values of the index of regulatory system tension during AOT suggest that in both groups the adaptive abilities of the mechanisms of vegetative regulation of cardiac rhythm were preserved.