Abstract: Objective: To investigate the correlation between hypertension and the formation of coronary atherosclerotic plaque by DSCTA. Methods: Collect patients who underwent coronary DSCTA from April 2014 to August 2015 and divided into hypertension group(n= 150) and non-hypertension group(n= 150) on the basis of cases. The hypertension group was divided into high pulse pressure(PP > 60 mm Hg) and low pulse pressure(PP < 60 mm Hg) group. The incidence rate of plaque, distribution characteristics and types were observed. Results: The incidence rate of 3 and above coronary artery vascular lesions was 61.7% in hypertension group and 45.3% in non hypertension group. The incidence rate of plaque was 28% in hypertension group and 19.2% in non hypertension group, the difference between the two groups were statistically significant(P < 0.05). The degrees of coronary artery stenosis between hypertension and non hypertension groups have no significant differences, but Severe stenosis was 8.6% and occlusion was 3.7% in high pulse pressure group; and were 4.4% and 0.8% respectively in low pulse pressure group, the difference were statistically significant(P < 0.05). Occurrence rate of mixed plaque was 54.5% in hypertension group and 43.0% in non hypertension group. The incidence of non calcified plaque was 40.6% in hypertension group, 50.7% in non hypertension group, the difference were statistically significant(P < 0.05). Occurrence rate of mixed plaque was 57.5% in group 1 and 49.1% in group 2,the difference between the two groups were statistically significant(P < 0.05). Conclusion: DSCTCA can evaluate the relationship between the hypertension and coronary artery plaque. The range of coronary involved by plaque is wider, incidence rate of mixed plaque is higher and having more risk prone to cardiovascular events in hypertension, and will be more serious with higher pulse pressure.