Primary hypertension is one of the major diseases that endanger human health and is the most dangerous and common factor causing cardiovascular diseases, which can affect the function of heart, brain and kidney and eventually lead to the failure of related organs, and is one of the main causes of cardiovascular disease death. Among the risk factors for cardiovascular disease, hypertension and homocysteine (Hcy) play a very important role. Therefore, it is equally important to control hypertension, a risk factor for cardiovascular disease, along with high Hcy. Homocysteine is a sulfur-containing essential amino acid, a class of sulfur-based amino acids that are intermediate products of methionine metabolism. The mechanism by which homocysteine causes cardiovascular disease is complex, but current research suggests that the pathways may include: superoxide and H2O2 produced by homocysteine can cause endothelial damage; alter coagulation factor levels and promote clot formation; and inhibit small arteries, making them more susceptible to clot-blocking injury; causing proliferation of arterial smooth muscle cells; and active homocysteine lactones, which can cause platelet aggregation. Animal studies have shown that homocysteine can cause endothelial cell detachment in arteries. In recent years, with the change of lifestyle, the prevalence of hypertension in China has increased significantly, which in turn causes vascular and organ lesions. A large number of studies have shown that elevated plasma homocysteine levels are an independent risk factor for cardiovascular disease, and its level is positively correlated with cardiovascular and cerebrovascular events. Simultaneous control of hypertension and hyperhcythaemia is an important measure to reduce the high incidence of stroke in China. In the newly revised hypertension guidelines in 2010, it has been clarified that Hcy is a risk factor for hypertension. Controlling hypertension while controlling Hcy levels is an important way to prevent stroke.