Introduction. Dispensary follow-up (DFU) for diseases of the circulatory system (DCS) is one of the key mechanisms for long-term outpatient management of patients in primary health care (PHC). However, regional variability of DFU indicators derived from federal statistical observation form No. 12, with consideration of age groups and nosological details, remains insufficiently studied. Objective. To study the dynamics and regional variability of dispensary follow-up indicators for diseases of the circulatory system in the adult population of the Russian Federation in 2018–2022. Material and methods. A complete retrospective analytical study was performed using data from federal statistical observation form No. 12 for 2018–2022 and Rosstat data on the adult population size. The rate of DCS cases among persons under dispensary follow-up at the end of the reporting year and the rate of DCS cases among persons placed under dispensary follow-up due to a newly established diagnosis were calculated per 100,000 population for the Russian Federation, federal districts, and 85 constituent entities. Additional nosological detailing was performed for hypertension and ischemic heart disease. Descriptive statistics, cluster analysis, and correlation analysis were used. Results. In 2018–2022, the rate of DCS cases among persons under dispensary follow-up at the end of the year increased from 17,399.7 to 23,371.4 per 100,000 adult population (+34.3%); the increase was 38.1% for hypertension and 17.3% for ischemic heart disease. The rate of DCS cases among persons placed under dispensary follow-up due to a newly established diagnosis increased from 2,399.1 to 2,999.1 per 100,000 (+25.0%), with a decline in 2020 and subsequent recovery. The highest values of both indicators were observed among persons older than working age. For the first indicator, three clusters of constituent entities were identified: high (n=14; centroid 30,017.3), medium (n=44; 20,849.9), and low (n=27; 12,558.0); the average silhouette measure was 0.6. For the second indicator, two clusters were identified: high (n=46; centroid 3,130.7) and low (n=39; 1,785.7); the average silhouette measure was 0.5. The correlation between primary incidence of DCS and the rate of DCS cases among persons placed under dispensary follow-up due to a newly established diagnosis was positive; a statistically significant Pearson correlation was found in Voronezh Region (r=0.9997; p