Abstract: Objective To investigate the clinical characteristics of essential hypertension（EH） and altitude-related hypertension（ARH） hospitalized in Qinghai, and to provide the relevant information for the prevention and treatment of ARH. Methods From February 2017 to December 2018, 1 987 hypertensive patients from 3.0-4.5 km altitude areas, and hospitalized in the department of hypertension in Qinghai Cardio-Cerebrovascular Hospital were enrolled in the study. One hundred and sixty-five patients who had elevated blood pressure（systolic blood pressure≥140 and/or diastolic blood pressure≥90 mm Hg） at high altitude and decreased to normal or decreased by more than 20/10 mm Hg under the same treatment regimen 2 weeks after arriving at Xining（2.26 km） were included in the ARH group. The other 1 822 patients were included in EH group. The general data, blood biochemical parameters, electrocardiogram, echocardiography, head CT, carotid ultrasound were collected in all patients. Results Compared with EH, ARH patients lived at higher altitudes （3 587.4±329.8） vs（3 404.9±300.7） m, t=6.855, P＜0.001 and had earlier onset age （48.0±11.5） vs（54.4±9.8） years, t=6.925, P＜0.001, higher percentage of male patients（77.6% vs 55.3%, χ~2=30.596, P＜0.001）, higher diastolic blood pressure（DBP） （115.8±18.5） vs（108.6±15.4） mm Hg, t=4.849, P＜0.001 and lower systolic blood pressure （165.9±21.3） vs（178.9±24.4）mm Hg, t=7.412, P＜0.001. Erythrocytes, hemoglobin, hematocrit and uric acid levels were higher in ARH patients than in EH patients（P＜0.05）. Echocardiography showed that the right atrium diameter （37.6±4.8） vs（35.8±3.5） mm, t=4.705, P＜0.001 and right ventricle diameter （43.4±3.8） vs（36.6±3.8） mm, t=22.011, P＜0.001 were enlarged in ARH than that in EH（P＜0.05）. The proportion of pulmonary artery hypertension in ARH group was higher than that in EH group（9.1% vs 4.9%, χ~2=5.397, P=0.020）, but there was no significant difference in the target organ damages and clinical complications caused by hypertension between the two groups. Logistic regression analysis showed that male, Han nationality, high-altitude living, elevated hemoglobin and uric acid, obesity were related to the occurrence of ARH. Conclusions ARH is a specific disease in the plateau area, which is prevalent in young and middle-aged men. Usually it can affect multiple systems and elevated blood pressure may be only one of its manifestations. ARH can still cause damages to corresponding target organs, which needs early recognition and aggressive prevention.