Objective:To explore the influence of metabolic syndrome (MS) on coronary artery disease in patients with hypertension .Methods :A total of 220 patients with hypertension were enrolled .According to complicated with MS or not ,they were divided into MS group (n=90) and pure hypertension group (control group ,n=130) . Coronary angiography was used to measure distribution and number of diseased coronary vessels ,Gensini scoring was also performed to compare and analyze severity of coronary disease between two groups .Results:Detection rate of CHD in MS group was significantly higher than that of control group (84.44% vs .71.54% ) ,χ2 = 4.974 , P=0.026. Compared with control group ,there were significant rise in percentages of left circumflex coronary artery (29.23% vs .44.44% ) and right coronary artery lesions (23.08% vs .38.89% ) , P<0.05 both ;significant rise in Gensini score [(32.69 ± 20.64) scores vs .(40.71 ± 25.79) scores ,P=0.011] and percentage of three -vessel coro‐nary artery disease (26.15% vs .40.00% ,χ2 = 4.700 , P= 0.03) in MS group .Conclusion:Metabolic syndrome significantly elevates severity of coronary artery disease in patients with hypertension .