Aim To investigate the value of hypertension with hyperuricemia for the assessment of the presence and severity of coronary artery disease(CAD). Methods The association between hyperuricemia with hypertension and the presence and severity of coronary artery disease was investigated in 662 patients with clinically suspected coronary artery disease.According to the incidence of hypertension and hyperuricemia all patients were divided into four groups.They were 91 cases of hypertension with hyperuricemia,259 cases of hypertensive patients.Hyperuricemia alone were 77 cases,and no disease of hyperuricemia and high blood pressure were 235 cases.All patients who underwent coronary angiography were divided into 458 cases of CAD group and 204 cases of non-CAD group based on the severity of coronary artery disease.Severity of coronary artery disease was evaluated using the Gensini score index. Results The serum uric acid levels(358.1±95.1 μmol/L) and the prevalence of hypertension(52.6%)and hyperuricemia(30.8%)were higher in CAD patients than those in without CAD(P<0.05).There were interactions between hyperuricemia and hypertension which were significant predictors for present of CAD.The Gensini scores of CAD patients who complicated with both hyperuricemia and hypertension were the highest.There was a linear trend between higher prevalence of hypertension with hyperuricemia and increasing numbers of disease vessel. Conlusion Serum uric acid in combination with hypertension may have some clinical significance in evaluating the degree and risk of coronary artery disease.