Abstract: Objective To explore the correlation between cumulative exposure to hypertension and carotid intima-media thickness（ CIMT） in the elderly. Methods A total of 3151 participants,who aged 60 years old or over and had completed the carotid sonography examination,were finally selected from the 1505 participants of the Stroke Cohort and 2235 participants of the Elderly Cohort from Tangshan Kailuan Group with 266 overlapping cases excluded. According to the cumulative exposure to hypertension（ 0,2,4,6 years）,all participants were divided into four groups. The correlation of cumulative systolic blood pressure（ cumSBP） and CIMT was analyzed with Pearson correlation and partial correlation analysis.Multivariate linear regression analysis was used to analyze the relationship between cumSBP and CIMT. And then Logistic regression models were performed to analyze the influence of cumulative exposure to hypertension on abnormal CIMT（ CIMT≥1 mm）. Results In 3151 participants included,2207 cases（ 70%） were male and 944 were female（ 30%）,with an average age of 68. 9 ± 7. 2. CIMT values in patients with the cumulative exposure to hypertension 0,2,4 and 6 years were（ 0. 91 ± 0. 18）,（ 0. 94 ± 0. 17）,（ 0. 96 ± 0. 18） and（ 0. 99 ± 0. 20） mm,respectively. And the corresponding abnormal CIMT detection rate was 33. 1%,40. 1%,44. 5% and 52. 8%. There was a positive correlation of cumSBP and CIMT indicated by correlation analysis（ r = 0. 14,P ＜ 0. 01）. Multivariate linear regression analysis revealed that cumSBP was positively related to CIMT after adjusting for the baseline risk factors（ B = 0. 017,P ＜ 0. 001）. Logistic regression analysis showed that compared with cumulative esposure to hypertension 0 year,cumulative exposure to hypertension 4 and 6years were still the risk factors of abnormal CIMT after adjusting for the other confounding factors,OR（ 95% CI） were1. 337（ 1. 013- 1. 763） and 1. 633（ 1. 200- 2. 221） respectively. Conclusion cumSBP is positively correlated with CIMT. Higher cumulative exposure to hypertension is risk factor of abnormal CIMT.