Aim To evaluate the effect of aspirin time-release on the incidence of cerebro-cardiovascular accidents in hypertensive patients. Methods This study was an opening, randomized, and controlled clinical prospective research, participated by 13 “the 3rd degree and grade A” hospitals and “the 2nd degree and grade A” hospitals which were organized by the cerebro-cardiovascular disease interventional net of hunan province coordinating center. 2 274 patients were randomly assigned to treatment group and control group. There are 1 286 patients in treated group assigned to aspirin 50～100 mg/d besides anti-hypertensive treatment, while 1 088 patients in control group received only routine anti-hypertensive therapy. The average follow-up time was 3.2 years (range 1～4 years). Finally 2 180 patients had completed the study which included 1 151 treated group patients and 1 029 control group patients. Results In treated group, the cumulative incidence risk of total cerebro-cardiovascular accidents, cerebral infarction, cerebral hemorrhage, myocardial infarction, total death, death caused by cerebro-cardiovascular accidents was 3.6%, 2.1%, 0.7%, 0.2%, 0.4%, 0.2%, but in control group the cumulative incidence risk of each event was 5.2%, 3.6%, 1.3%, 0.9%, 0.4%, 0.3%. The study observed that active treatment obviously reduced the incidence of fatal and non-fatal acute myocardial infarctions (p<0.05), compared with the controll group, the relative risk (95% confidence interval,95% CI) was 0.204 (0.044～0.943). But the relative risk of cerebro-cardiovascular accidents, cerebral infarction, cerebral hemorrhage was 0.701 (0.469～1.048), 0.815 (0.470～1.412), 0.567 (0.235～1.368), respectively, which are nonsignificant. Furthermore, the relative risk of death caused by cerebro-cardiovascular accidents was 3.645 (0.407～32.614). Conclusions The active therapy with low-dose aspirin could significantly reduce the incidence of fatal and non-fatal acute myocardial infarctions in hypertensive patients. And there was no increased risk of stroke or bleeding. So it has effect on the primary prevention.