Objective To investigate the effects of simvastatin combined with amlodipine on blood pressure, carotid atherosclerosis and left ventricular structure in patients with essential hypertension.Methods 106 hypertensive patients admitted in our hospital from March 2015 to November 2016 were randomly divided into control group and observation group. The control group was treated with amlodipine and the observation group was treated with simvastatin on the control group. After 8 weeks of treatment, the changes of blood pressure, blood lipid, carotid atherosclerosis and left ventricular structure were analyzed and compared between the two groups. Results The total effective rate in observation group (9434%) was higher than that in control group (84.90%) (P＜0.05).The levels of SBP and DBP in each group before treatment were significantly lower that after the treatment (P＜0.05). The levels of SBP and DBP in observation group were significantly lower than that in control group (P＜0.05). After the treatment, the levels of TC, TG and LDL-C were significantly lower than those before treatment (P＜0.05). The level of HDL-C were significantly higher than that before treatment(P＜0.05). Meanwhile, the levels of TC, TG and LDLC in the observation group were significantly lower than those in the control group(P＜0.05). The level of HDL-C in the observation group was significantly higher than that in control group (P＜0.05). After the treatment, IMT and the plaque area in both groups were significantly lower than those before treatment(P＜0.05), IMT and the plaque area in observation group were significantly lower than the control group (P＜0.05). The levels of IVST, LVPWT and LVDd in the observation group were significantly lower than those in the control group (P＜0.05). Conclusion Simvastatin combined with amlodipine can downregulate the blood pressure and blood lipid level in patients with hypertension, reduce the risk of atherosclerosis and reverse the left ventricular hypertrophy.