Abstract: Abstract: Objective　To analyze the relationship between electrocardiogram (ECG) T wave amplitude in precordial leads and ambulatory blood pressure in patients with essential hypertension, and to investigate the relationship between cardiac electrical remodeling and blood pressure control. Methods　A total of 360 patients with primary hypertension with classified as grade 2 or above were enrolled in the study. Patients were divided into two groups according to the result of 24-hour ambulatory blood pressure monitoring (24 h ABPM): the controlled group (n=53) and the un-controlled group (n=307). The clinical data including baseline data, 24 h ABPM, ECG and laboratory indicators were collected in the two groups. The general data such as baseline data and T wave amplitude of precordial leads were analyzed between the two groups. Logistic regression analysis was used for analyzing factors predicting blood pressure control failure in patients with primary hypertension. Results　Compared with the blood pressure control group, the male patients were more common in the blood pressure uncontrol group (P＜0.05). The amplitude of T wave in lead V1 of ECG was increased (P＜0.05), and the proportion of patients with TV1＞TV5, V6 and V6 T/R＜1/10 increased (P＜0.05). The mSBP, nSBP and nDBP were increased in patients with TV1＞TV5, V6 (n=90) than those of patients without TV1＞TV5, V6 (n=270). The mSBP, dSBP, nSBP and nDBP were significantly increased in patients with V6 T/R＜1/10 (n=119) than those of patients without V6 T/R＜1/10 (n=241, P＜0.05). Logistic regression analysis showed that the increase of T wave amplitude in leads V1 and V3 and the increase in the proportion of patients with TV1＞TV5, V6 and V6 T/R＜1/10 before adjusting for age, gender, hypertension grade, duration of hypertension and types of antihypertensive drugs were the risk factors for substandard blood pressure control in hypertensive patients. After adjusting for confounding factors, only the increase in the ratio of TV1＞TV5, V6 and V6 T / R＜1/10 was the independent risk factor for the failure of blood pressure control (OR= 3.145, 2.632. 95% CI: 1.156-8.556, 1.067-6.449, all P＜0.05). But the increased T wave amplitude in leads V1 and V3 was not the risk factor for the failure of blood pressure control. Conclusion　The ECG TV1＞TV5, V6 and V6 T/R＜1/10 is related with the failure of blood pressure control in patients with primary hypertension.

Key words: hypertension, electrocardiography, blood pressure control situation, cardiac electrical remodeling, T wave amplitude