Objective: To compare the effectiveness of vascular ultrasonography and proteinuria in diagnosing systemic vascular damage. Subjects and methods: Forty healthy pregnant women, 35 with preeclampsia, and 35 with non-proteinuric hypertension in the Yanahuara and Nacional del Sur hospitals in Arequipa (Peru) underwent measurement of blood pressure, proteinuria, and ultrasonographic studies in the humeral artery to obtain their flow-mediated dilation (FMD). Comparisons between the three groups were made using ANOVA or Kruskal-Wallis tests, depending on whether the distribution was normal or non-normal, respectively. Values of P<0.05 were considered statistically significant. Results: Proteinuria values were 0.05 g/24 h, 2.57 g/24 h and 0.21 g/24 h while FMD values showed mean values of 0.66mm, 0.25mm, and 0.45mm for healthy pregnant women, women with preeclampsia and women with non-proteinuric hypertension, respectively. Comparison of FMD among groups showed significant differences among the groups (P<.01). However, proteinuria values in the group with non-proteinuric hypertension were within the normal range (< 0.03 g/24 h). No relation was found between FMD and proteinuria. Conclusions: Ultrasonographic evaluation of FMD detected vascular damage even in the group of pregnant women with pregnancy-induced hypertension without proteinuria. © 2009 Sociedad Española de Ginecología y Obstetricia.