Abstract: Objective: To assess the relationship between ascending thoracic aorta distensibility and hypertension in coronary artery disease (CAD) patients by 64-multidetector computed tomography. Method: In all, 135 patients with suspected CAD were enrolled in this study and underwent retrospective ECG-gated coronary CTA and CAG. Every patient's blood pressure was measured before and after the coronary CTA respectively. The ascending aortal images of 20 phases between 0% and 95% of the R-R intervals with an increment of 5% was reformatted and the aortal area of the images was measured by MATLAB software, and then we can calculate the aortic distensibility. The patients can be divided into hypertension subjects (n = 81) and normal subjects (n = 54). Result: The aortic distensibility of the Patients was remarkably lower in hypertension subjects than that in normal subjects(t= 7.81, P ＜ 0.001). Multivariate linear regression demonstrated that hypertension was the independent risk thctors of aortic distensibility (B = -0.835, t = 7.18, P ＜ 0.001). Conclusion: The ascending thoracic aorta distensibility had a significant relationship with hypertension. The estimate of aortic distensibility may play an important role in the prediction of cardiovascular disease.