Aim To explore the effect of apolipoprotein E (Apo E) polymorphism on lipid and essential hypertension. Methods Polymerase chain reaction restricted fragments length polymorphism was used to determine the Apo E genotypes in 112 cases with essential hypertension and 118 controls without hypertension. Results The ε4 allele frequency and the Apo E ε4 carriers was significantly higher in the hypertensive patient group than that in the group of normotensive control (p<0.05). The subjects carrying Apo E ε4 had significantly higher levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDLC) than those carrying Apo E ε2 (p<0.05);the Apo E ε3/ε3 carriers had significantly higher LDLC levels than the Apo E ε2 carriers (p<0.05). The Apo E ε4 was an independent risk factor for essential hypertension (p<0.05). Conclusions The Apo E gene polymorphism affects plasma levels of lipids and lipoproteins. The Apo E ε4 may be an important risk factor for essential hypertension.