Abstract: Objective To evaluate the correlation between atherogenic index of plasma（AIP）and coronary artery lesions in hypertensive geriatrics by Gensini score. Methods A total of 828hypertensive patients aged above 60years old,who were admitted to Tianjin Chest Hospital from May 2009to May 2010and diagnosed coronary heart disease by coronary angiography,were enrolled in this study. The patients whose Gensini score was no less than 30were in high Gensini（H-Gensini）group（n=384）,and those with Gensini score less than 30were in low Gensini（L-Gensini）group（n=444）. The other factors of two groups,such as age,gender,smoking history,myocardial infarction history,body mass index（BMI）,systolic blood pressure,diastolic blood pressure,fibrinogen（FIB）,fasting blood glucose（FBG）,AIP,total cholesterol（TC）,triglyceride（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,serum urea,creatinine,uric acid,serum potassium,left atrial anterior-posterior diameter（LAAPD）,left ventricular end-diastolic diameter（LVEDD）,left ventricular ejection fraction（LVEF）and pulmonary arterial systolic pressure（PASP）,were compared. Multivariate Logistic regression analysis was performed to evaluate the assosiation between the above indexes and coronary artery lesions.Results Compared with those in L-Gensini group,the age（70.3±6.9）vs（69.2±7.0）years,BMI（25.7±1.6）vs（25.3±3.2）kg/m2,FBG （6.8±2.1）vs（5.6±1.2）mmol/L,AIP（0.11±0.19）vs（0.08±0.17）,LVEDD（51.5±5.2）vs（50.7±6.8）mmand PASP（38.9±6.0）vs（31.9±3.7）mm Hgof H-Gensini group were higher,while diastolic blood pressrue（84.5±13.8）vs（89.7±18.8）mm Hgand serum potassium （4.12±0.44）vs（4.15±0.40）mmol/Lwere lower（all P＜0.05）in H-gensini group. Non-conditional Logistic regression analysis showed that age,smoking history,diastolic blood pressure,AIP,FBG,and PASP were the influencing factors of coronary artery lesions in elderly hypertensive patients（all P＜0.05）. Among these factors,AIP（β=1.621,OR=5.057）had the maximum correlation with coronary artery lesions. Conclusion AIP is correlated with coronary artery lesions in hypertensive geriatrics.