Microalbuminuria and peripheral artery disease represent 2 different forms of target organ damage due to raised blood pressure. The aim of this study was to investigate the association between blood pressure with microalbuminuria and the appearance of peripheral artery disease after more than a decade, and moreover, to address whether any relationship exists between microalbuminuria and peripheral disease in a Greek Caucasian population. In 1990, 635 normal subjects were examined and their blood pressure was recorded. Nine and 12 years later, subjects were reexamined and 361 of them (57%) were available at last visit for the determination of microalbuminuria and ankle-arm index. Microalbuminuria was detected in 35/361 (9.7%) and peripheral artery disease in 89/361 (24.7%). Both conditions were statistically correlated with pulse and systolic blood pressure at all time points during the 12-year follow-up period, while the relationship with diastolic and mean arterial pressure existed only for baseline values and was then abolished. Microalbuminuria was statistically correlated to peripheral artery disease (r = −0.460, p = 0.0001). Blood pressure levels seemed to predict the appearance of microalbuminuria and peripheral disease after 12 years. Microvasculature and macrovasculature abnormalities (microalbuminuria and peripheral disease, respectively) showed a significant relationship, suggesting a common pathogenetic mechanism.