Aim To discuss the relationship between ambulatory blood pressure monitoring(ABPM) parameters and carotid artery intima-media thickness(CA-IMT) in elderly hypertensive patients. Methods According to the results of carotid artery ultrasound examination the 205 patients divided into three groups:the patient were classified into the non-increased IMT group(control group)(IMT<1.0 mm),the increased IMT group(1.0 mm P><0.05).The incidence of coronary heart disease were 42.1% in the non-increased IMT group,53.1% in the increased IMT group,89.5% in the increased IMT with plaque group.The percent of dippers was 54.3%,62.9%,77.6% in each group.Which had significantly difference(P><0.05). The mean IMT had a positive correlation with 24hSBP,dSBP,nSBP,24hPP,dPP,nPP and the incidence of coronary heart disease(r=0.487,r=0.514,r=0.469,r=0.448,r=0.492,r=0.435,r=0.878,P><0.05).Which had significantly difference(P><0.05). Conclusion The rising of 24 hSBP,nSBP,24 hPP,nPP and patients who have lost the normal dipper rhythm of ambulatory blood pressure obviously will lead to the increase of IMT and the rising of plaque formation,which had a good correlation with the occurrence of coronary hart disease.