OBJECTIVE： To observe the efficacy and safety of vinpocetine in the treatment of acute coronary syndrome （ACS） with hypertension. METHODS： 90 patients with ACS and hypertension were randomly divided into control group （45 cases） and observation group （45 cases）. Control group received Atorvastatin calcium tablet 20 mg， orally， once a day+Clopidogrel hydrogen sulfate tablet 75 mg， orally， once a day+Levamlodipine besylate tablet 2.5 mg， orally， once a day+Isosorbide mononitrate sustained-release tablet 40 mg， orally， once a day. Observation group was additionally given Vinpocetine injection 30 mg， adding into 0.9％ Sodium chloride injection or 5％ Glucose injection 250 ml by intravenous infusion， once a day. The 2 groups were treated for 14 d. The clinical efficacy， systolic blood pressure （SBP）， diastolic blood pressure （DBP）， attack frequency， duration， interval time of the attack， ST segment down， blood viscosity， D-dimer， platelet aggregation rate， fibrinogen levels before and after treatment， and the incidence of adverse reactions in 2 groups were observed. RESULTS： The total effective rate in observation group was significantly higher than control group， with statistical significance （P＜0.05）. Before treatment， there were no significant differences in SBP， DBP， attack frequency， duration， interval time of the attack， ST segment down， blood viscosity， D-dimer， platelet aggregation rate， fibrinogen levels in 2 groups （P＞0.05）. After treatment， SBP and DBP in 2 groups were significantly lower than before， with statistical significance （P＜0.05）， while there was no significant difference in 2 groups （P＞0.05）. Attack frequency， duration，ST segment down， blood viscosity， D-dimer， platelet aggregation rate， fibrinogen levels in 2 groups were significantly lower than before， and observation group was lower than control group， interval time of the attack in 2 groups was significantly long than before，and observation group was longer than control group，with statistical significances （P＜0.05）. And there was no significant difference in the incidence of adverse reactions in 2 groups （P＞0.05）. CONCLUSIONS： Based on the conventional treatment， both efficacy and safety of vinpocetine in the treatment of ACS with hypertension are good.