Abstract: AIM To investigate the relationship between hypertension classifications and clinical events in patients with coronary artery lesions. METHODS Data of 276 patients undergoing coronary angiography were collected. On the basis of blood pressure levels, patients were divided into normal blood pressure group(n=82), essential hypertension(EH) I group(n=58), EH Ⅱ group(n=65) and EH Ⅲ group(n=71). Gensini score was used for coronary assessment. Results of coronary angiography and incidence of clinical events were analyzed in each group and compared between groups. RESULTS The constituent ratio of coronary artery lesion degree was different in each group. The ratio of severe coronary artery lesion in normal blood pressure group was the lowest, whereas that of the EH Ⅲ group was the highest(P<0.05). Multiple regression analysis showed that age, smoking, diabetes and high blood pressure were risk factors of Gensini score, and HDL-C was a protective factor. With the increase in blood pressure, rate of clinical events markedly increased(P<0.05). CONCLUSION Increasing blood pressure worsens coronary artery lesions and increases the clinical event rate.