OBJECTIVE： To prospectively study the effects of trimetazidine on myocardial remodeling and oxidative stress in patients with hypertensive heart disease （HHD）， in order to provide reference for clinical treatment of HHD. METHODS： Eighty-two HHD patients were selected from our hospital during Jan. 2014-Jul. 2016， and they were divided into control group and observation group by sortition randomization method， with 41 cases in each group. Control group received routine HHD chemical drug （antihypertensive drugs， lipid-lowering drugs， hypoglycemic agents and antiplatelet drugs， etc.） therapy. Observation group was additionally given trimetazidine 20 mg， tid， on the basis of control group. Both groups were treated for 3 months. Before treatment and after 3 months of treatment， SBP， DBP， New York Heart Association （NYHA） cardiac function grade， LVEF， LVESD， LVEDD， LVMI and the levels of GSH-Px， SOD， MDA and ROS were compared between 2 group. The occurrence of ADR was observed in 2 groups. RESULTS： Before treatment， there was no statistical significance in each index between 2 groups （P＞0.05）. After 3 months of treatment， SBP and DBP of 2 groups were decreased significantly compared to before treatment （P＜0.01）； there was no statistical significance between 2 groups （P＞0.05）. There was no statistical significance in NYHA cardiac function grade compared to before treatment or between 2 groups （P＞0.05）. LVESD， LVEDD and LVMI of observation group were decreased significantly compared to before treatment （P＜0.05）； LVEF was increased significantly compared to before treatment （P＜0.05）； LVEDD and LVMI of observation group were significantly lower than control group （P＜0.05）. Compared to before treatment， SOD level of control group was decreased significantly， while the levels of GSH-Px and SOD in observation group were increased significantly； MDA and ROS of observation group were significantly lower than those of control group， with statistical significance （P＜0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS： Trimetazidine can improve cayocardial remodeling and reduce oxidative stress level of HHD patients with good safety.