Abstract： Objective This study aims to explore the relationship between low-density lipoprotein cholesterol(LDL-C),residual cholesterol(RC)and cardiovascular events in elderly patients with essential hypertension.Methods 138 elderly essen-tial hypertension patients were divided into 32 cases and 106 cases according to the occurrence of adverse cardiovascular events.The general data,admission serum TC,HDL-C,LDL-C,RC level,and neurological function score(NHISS)were compared between the two groups,and the ROC curve was used to analyze the prediction value of the above index level of cardiovas-cular events in patients with essential hypertension.Results Comparison of disease duration,dietary habits,blood pressure level,hypertension grades Ⅱ-Ⅲ,family history of CAD in the incident and no incident group,The difference was statistically significant(P<0.05);High lipid levels TC,HDL-C,and RC in the incident group compared with patients in the naive group,LDL-C was lower than that in the untreated group,The difference was statistically significant(P<0.05);Higher left ventricular end diastolic internal diameter(LVDD),left ventricular systolic end internal diameter(LVSD)than the occurrence group,Low left ventricular ejection fraction(LVEF)than in the untreated group,The difference was statistically significant(P<0.05);Area under the ROC curve of serum lipid TC,HDL-C,LDL-C,and RC levels for predicting cardiovascular events in patients(Area Under Curve,AUC)were 0.693,0.694,0.754,and 0.769,respectively,Sensitivity was 68.75%,62.50%,78.12%,and 62.50%,re-spectively,Specific was 68.87%,73.58%,64.15%,88.68%,The difference was statistically significant(P<0.05).Conclusions TC,HDL-C,LDL-C and RC levels are associated with cardiovascular events in elderly patients with essential hypertension and can be used to assess potential cardiovascular disease risk.