Aim To analyze the characteristics of carotid artery morphology and hemodynamics before and after atherosclerosis (As) in subjects with different blood pressure levels, and to provide evidence for the early prevention and treatment of atherosclerosis in different blood pressure groups. Methods 308 subjects (age range 40～65 years, mean age 52.2±4.7 years) were screened and divided into normal blood pressure group, normal high blood pressure group, gradeⅠhypertension group, exclusion of major cardiovascular diseases, such as atherosclerosis, coronary heart disease, etc. The carotid intima-media (IMT), resistance index (RI), pulse index (PI), peak systolic velocity (PSV) and internal diameter were measured by GE vivid 7 Color Doppler, blood flow wall shear force (WSS) was calculated and four blood lipids were detected by blood biochemical analyzer. Results Age, heart rate, body mass index (BMI), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC) in the three groups did not show significant difference, BMI did not reach the standard of obesity, the basic information in the three groups had no significant difference. Systolic blood pressure and diastolic blood pressure in hypertension group were significantly higher than those in normal high blood pressure group and normal blood pressure group (P＜0.05). In normal high blood pressure group, systolic blood pressure and diastolic blood pressure were significantly higher than those in normal blood pressure group (P＜0.05), and the subjects were successfully grouped according to blood pressure level. PSV in normal high blood pressure group and grade I hypertension group was higher than that in normal blood pressure group, PSV in normal high blood pressure group was higher than that in grade I hypertension group, PSV,PI and RI had no signifcant difference in the three groups. WSS in normal high blood pressure group and grade I hypertension group was significantly lower than that in normal blood pressure group (P＜0.05). The diameter of carotid artery in normal high blood pressure group and grade I hypertension group was significantly higher than that in normal blood pressure group (P＜0.05), and IMT had no significant difference between the two groups. Conclusion The carotid artery diameter increased and WSS decreased in the two groups of non atherosclerotic middle-aged people with elevated blood pressure. WSS in non atherosclerotic people with different blood pressure is more sensitive than PI and RI.