Abstract: AIM To investigate the correlation between blood lipids and coronary atherosclerosis(CA) in prehypertensive patients of both genders and the independent risk factors of CA. METHODS A total of 116 patients with prehypertension(73 males and 43 females, average age 40-75 years) were divided into CA group and normal group according to the results of coronary angiography. Baseline characteristics were compared between groups. Grouped by blood lipid levels, Gensini score was compared between patients of both genders. Logistic regression analysis was performed for the independent relevant factors of CA. RESULTS Age, LDL-C, smoking, diabetes mellitus and family history of coronary heart disease in CA group were significantly higher than in the normal group. The same differences, except family history of coronary heart disease, were also found in male patients. In female patients, statistical differences were found in age, LDL-C and family history of coronary heart disease. According to Gensini scores, elevated LDL-C and high cholesterol(TC) were found in male patients. Regression analysis showed that age and LDL-C were independent relevant factors of CA. CONCLUSION LDL-C and TC increase coronary atherosclerosis in male prehypertensive patients. Age and LDL-C are independent relevant factors of CA in prehypertensive patients.