For early diagnosis of hypertensive disease, it is not enough to take into account only office blood pressure readings. 24-hour driving blood pressure monitoring shows an increase in mean systolic blood pressure (SBP) by 15.7% and in mean diastolic blood pressure (DBP) by 15.2% as compared to the data obtained on undriving. Blood pressure monitoring in locomotive crew mates could diagnose workplace hypertension in 14.7%; in 7.6% of them the diagnosis was first established. On driving, the patients with protracted workplace hypertension showed 3.9 and 9.1% increases in the mean SBP and DBP values by respectively, as compared with those who had essential hypertension. This method can also estimate the time of complete rest required for locomotive crew mates after train driving. The patients with workplace hypertensive disease achieve normal SBP and DBP values at rest twice as fast as those with essential hypertension. Paired blood pressure monitoring in locomotive crew mates permits the diagnosis of workplace hypertensive disease in its early stages and it is able to provide quality control of preventive and therapeutic measures in patients with different forms and stages of hypertensive disease.