〔Abstract〕 Objective To investigate clinical prediction value of BNP combined with cardiac structural index in hypertension patients with heart failure. Methods 320 patients with hypertension were divided into control group(n=52), septal thickening group(n=48), left ventricular wall thickening group(n=40), left atrial enlargement group(n=46), left ventricular hypertrophy group(n=66), left atrial and left ventricular enlargement group(n=68). General data, BNP level, left atrial diameter(LAD), interventricular septal(IVS), left ventricular end diastolic diameter( LVEDD),left ventricular ejection fraction( LVEF) and left ventricular posterior wall( LVPW)were recorded. The differences of each index in six groups were compared,and the correlation among these indexes,the changes of cardiac structure and the occurrence of heart failure in patients with hypertension was analyzed.Results BNP,LAD and LVEDD in each group of cardiac remodeling were higher than those in the control group.BNP,LAD and LVEDD increased with the severity of cardiac remodeling( P<0. 05). The correlation analysis of LVEF with BNP and cardiac structure showed that LVEF was negatively correlated with BNP,LAD and LVEDD( r=-0. 584,-0. 430,-0. 764,P<0. 001,P<0. 001,P<0. 001). ROC curve analysis showed that the area under the curve of BNP,LAD,LVEDD alone and combined diagnosis of HFREF was 0. 845,0. 725,0. 940 and0. 954,respectively. The sensitivity and specificity of combined detection of BNP,LAD and LVEDD for HFREF were 94. 6% and 89. 5% respectively,which were higher than that of single detection of each index. Conclusion The plasma BNP level has a good clinical predictive value for the changes of cardiac structure and function in patients with hypertension. Combining BNP,LAD and LVEDD can improve the diagnosis of HFREF in hypertension patients.