Objective: To analyse the relationship between serum homocysteine levels, inflammatory response and plaque stability in patients with H- type hypertension and carotid atherosclerosis. Methods: From February 2021 to May 2022, a total of 1,500 registered households in Baoding, China were surveyed. The results showed that 600 cases displayed high risk of H-type hypertension, of which 100 cases were directly diagnosed with H- type hypertension or transient cerebral ischemia. A questionnaire was carried out among the selected cases. According to the management methods of the pilot project of screening and intervention for groups at high risk of H- type hypertension, a questionnaire regarding multiple risk factors was developed. These factors included hypertension, real estate and heart valve disease, smoking, dyslipidemia, diabetes and so on. Results: Risk factors for plasma homocysteine include smoking and diabetes, and risk factors for carotid plaque include diabetes, hypertension, LDL- C abnormalities and plasma homocysteine. Through Pearson linear analysis, serum homocysteine levels in patients with H- type hypertension were positively correlated with HCGP-39, TNF-alpha, Hs-CRP, IL-1 beta, PTX3 and Lp-PLA2 and negatively correlated with TBIL, DBIL and IBIL. Conclusion: In the community medical system, it is important to implement prevention and treatment of H- type hypertension among high- risk populations, pay attention to the relationship between plasma homocysteine and blood lipid levels and practice timely prevention and early intervention regarding carotid plaque.