Objective To study the effect of microalbuminuria (MAU) on artery elasticity in middle-aged and elderly essential hypertension (EH) patients with CHD.Methods Two hundred and forty-six EH patients were divided into middle-aged EH group (n=114) and elderly EH group (n=132) with 45 EH-free subjects undergoing physical examination served as a control group.The CF-PWV,Ba-PWV and CSP in patients included in this study were measured with an arteriosclerosis detector.Results The volume of ACR and incidence of CHD were significantly higher in middle-aged and elderly EH groups than in control group (19.30％ and 16.67％ vs 0％,P＜0.05).The number of 1-,2-and 3-branch lesions was significantly greater,the ba-PWV and ACR volume were significantly higher in elderly EH group than in middle-aged EH group (P＜0.05).The number of 3-branch lesions was significantly greater,the CSP,CF-PWV,ba-PWV and ACR volume were significantly higher in middle-aged and elderly EH groups with 3-branch lesions than in those with 1-and 2-branch lesions (P＜0.05).Multivariate linear regression analysis showed that age,CF-PWV,CSP,MAU were positively associated with the number of coronary artery lesions (P＜0.05,P＜0.01).Conclusion CF-PWV and CSP can show the severity of CHD and renal damage.The renal vascular damage is exacerbated in elderly EH patients with CHD.