Abstract: Objective To explore the risk factors for cognitive impairment in veterans with hypertension. Methods A total of 162elderly essential hypertensive veterans who received antihypertensive treatment with good adherence was enrolled in this study. All participants underwent carotid artery ultrasound scanning,cranial computerized tomography and magnetic resonance imaging. Cognitive function was evaluated by Mini-Mental State Examination Scale（MMSE）. According to MMSE score,all participants were divided into cognitive impairment group（n=73）and normal cognition group（n=89）. Logistic regression was used to analyze the factors associated with cognitive dysfunction. Results Compared with those in normal cognition group,the hypertension duration（23.9±6.8）vs（15.9±7.6）years,P＜0.01,plasma homo-cysteine level（Hcy）,and carotid intima-media thickness（IMT）（22.12±5.16）vs（17.11±3.87）μmol/L,（1.12±0.14）vs（1.01±0.15）mm,all P＜0.01in the cognitive impairment group were all greater,and the detection rates of carotid atherosclerosis（CAS）,cerebral infarction,subcortical arteriosclerotic encephalopathy（SAE）and cerebral atrophy were also higher60.27%vs 6.74%,97.26%vs74.16%,79.45%vs 19.10%,and 86.30%vs 55.06%,respectively;all P＜0.01. Multivariate non-conditional logistic regression analysis showed that hypertension duration,Hcy,carotid atherosclerosis and subcortical arteriosclerotic encephalopathy were the risk factors for cognitive impairmentOR（95%CI）:3.65（1.57-8.52）,16.70（4.02-69.39）,76.69（10.82-543.86）,and 24.25（6.03-97.49）,respectively. Conclusion Cognitive impairment in veterans with hypertension is associated with hypertension duration,plasma Hcy level,carotid atherosclerosis and SAE.