A polymorphism in the cytochrome P450 3A CYP3A5 enzyme has been implicated in BP (blood pressure) control and arterial hypertension. Carriers of the CYP3A5*1 allele had high, whereas homozygous carriers of the CYP3A5*3 allele exhibit low, CYP3A5 expression in the kidney, where CYP3A5 represents the major CYP3A enzyme. The aim of the present study was to investigate the association of the CYP3A5*1 allele with BP, arterial hypertension, LVM [(left ventricular) mass] and LV geometry in a large Caucasian-population-based cohort. We compared BP, LVM and the prevalence of hypertension between carriers (CYP3A5*1/*1 and CYP3A5*1/*3 genotypes) and non-carriers (CYP3A5*3/*3 genotype) of the CYP3A5*1 allele in the echocardiographic substudy of the third MONICA (MONItoring trends and determinants in CArdiovascular disease) Augsburg survey. After exclusion of 269 individuals who were taking antihypertensive medication, 530 women and 554 men were available for analysis, revealing allele frequencies of 5.8 and 94.2% for the CYP3A5*1 and CYP3A5*3 alleles respectively. Overall, the presence of the CYP3A5*1 allele exhibited no effect on systolic or diastolic BP in either gender. One-third of the individuals in this cohort were hypertensive (BP ≥140/90 mmHg), and the genotype distribution between normotensive and hypertensive individuals revealed no association between CYP3A5*1 and hypertension after adjustment for age, BMI and gender (odds ratio, 1.02; P=0.92). Moreover, no effect of CYP3A5*1 on LVM, thickness of the septal and posterior wall and LV end-diastolic diameter was found. We conclude that CYP3A5*1 exhibits no significant effect on BP, LVM and LV geometry in the KORA/MONICA echocardiographic substudy.