Aim To access the relationship between carotid lesions and some vasoactivators in patients with hypertension. Methods 105 hypertensive patients were divided into four groups based on the result of carotid arterial sonography: normal group(30 cases), endothelial thickness group(30 cases), hard plaque group(30 cases) and soft plaque group(15 cases). Several vasoactivators were determined in these patients, including nitrogen monoxide(NO), endothelin(ET), neuropeptide Y(NPY), fibrinogen(FIB), low density lipoprotein(LDL) and total cholesterol(TC). Results Compared with non-plaque group,soft plaque group had higher levels of LDLC,NPY, FIB and lower levels of NO. The difference was significant(P<0.05). Hard plaque group had also different levels of above vasoactivor parameters from that of normal group (P<0.05). Conclusion There was a significant association between the formation of carotid atherosclerotic lesions and the hypertensive injury and disorders of lipids metabolism.