【Abstract】 Objective To investigate the effect of hemoperfusion and dialysis on blood pressure, plasma ET1 and Lep levels in maintenance hemodialysis patients with longterm hypertension. Methods 94 patients of maintenance hemodialysis comlicated with long term hypertension in our hospital from March 2016 to February 2017 were selected. According to the different methods of hemodialysis, 94 patients were divided into routine hemodialysis group and blood perfusion combined routine dialysis group. The changes of blood pressure, laboratory blood parameters, body minerals, bone metabolism and quality of life were compared between the two groups. Results The systolic blood pressure and diastolic blood pressure at 4, 8 and 12 weeks in the hemodialysis group were slightly lower than those before treatment, but the difference was not statistically significant (P＞005). The systolic blood pressure and diastolic blood pressure at 4, 8 and 12 weeks in Hemoperfusion combined with routine dialysis group were significantly lower than those in the conventional hemodialysis group (P＜005). The levels of plasma endothelin1 (ET1) and leptin (Lep) were significantly higher in the conventional hemodialysis group after 12 weeks of treatment than those before treatment (P＜005). The levels of ET1 and Lep in the hemoperfusion combined with conventional hemodialysis group after 12 weeks of treatment were significantly lower than those before treatment. At the same time after treatment, the levels of ET1 and Lep in hemoperfusion combined with conventional hemodialysis group were significantly lower than those in conventional hemodialysis group (P＜005). After treatment, the levels of CRP and IL6 in the blood perfusion combined with the conventional dialysis group were significantly greater than that of the conventional hemodialysis group (P＜005). After treatment, there were obvious changes in the indexes of FGF23, iPTH, Ca, P, βCTX and PINP in the blood perfusion combined with the conventional dialysis group with a decreased trend(P＜005), and the indexes in the blood perfusion combined with the conventional dialysis group were lower than those in the routine hemodialysis group (P＜005). The scores of role function, emotional function, cognitive function and social function in the blood perfusion combined with routine dialysis group were significantly higher than those of routine hemodialysis group(P＜005). Conclusion Hemoperfusion combined with conventional dialysis can effectively reduce the blood pressure level in maintenance hemodialysis patients with longterm hypertension, and improve plasma ET1 and Lep levels, but the blood perfusion combined with conventional dialysis has a certain influence on the body mineral and bone metabolism index of the patients, and the corresponding preventive measures should be taken to the patients during the treatment.