Aim To explore the association of fibrinogen gene polymorphism with hypertension ischemic complications. Methods The Fibrinogen β-455G/A gene polymorphism was identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 149 hypertensive cases without complication, 124 hypertension cases with coronary heart disease and 148 matched controls by age and sex. Turbidimetric assays were performed to measure the plasma fibrinogen levels of all cases. Results The plasma fibrinogen level in coronary heart disease group was significantly higher than that in the controls (p<0.01) and hypertension patients (p<0.05). The A-allele was associated with elevated plasma fibrinogen levels in both patients and controls. In A-allele carriers with coronary heart disease, the older people had significantly higher plasma fibrinogen levels than the younger (p<0.05). The distribution of β-455G/A gene polymorphism was in accordance with the Hardy-Weinberg equilibrium (p>0.05). The A-allelic frequency in the coronary heart disease group was 0.238, significantly higher than that in the control group (0.152) and hypertension group (0.171; p<0.01), but there was no significantly difference between the control group and hypertension group (p>0.05). Logistic regression analysis showed that the relative risk to coronary heart disease in the hypertensions carrying A-allele (GA+AA genotype) increases 1.637 times. Conclusions The study demonstrates that fibrinogen is the important risk factor for the cardiovascular diseases. The plasma fibrinogen levels are affected by both genetic and environmental factors. The fibrinogen β-55G/A gene polymorphism may influence the progress of the coronary heart disease by regulating plasma fibrinogen levels. Genetic factor is associated with coronary heart disease.