Abstract: Objective To analyze the effect of enalapril maleate folate tablets on homocysteine(Hcy) in patients with H-type hypertension, in order to explore the effective treatment of the disease and promote the early recovery of patients. Methods A total of 86 patients with H-type hypertension diagnosed and treated in our hospital from September 2018 to September 2019 were divided into group A(43 cases) and group B(43 cases) according to the sequence of admission. Enalapril maleate tablets and enalapril maleate folate tablets were used for treatment respectively, and the blood pressure level(systolic and diastolic pressure), blood pressure reduction effect, Hcy level and carotid ultrasonography results(Intima-media thickness and plaque area of common carotid artery) of the two groups were compared. Results The systolic blood pressure and diastolic blood pressure of group B[(119.5±9.2) mm Hg,(79.5±7.0) mm Hg] were lower than those of group A[(136.3±10.4) mm Hg,(87.1±8.3) mm Hg], the difference were statistically significant(t=7.934, 4.590, all P<0.05). The total effective rate of group B(93.0%, 40/43) was higher than that of group A(76.7%, 33/43), the difference is statistically significant(χ²=4.440, P<0.05). The Hcy level of group B[(10.5±3.3) μmol/L] was lower than that of group A[(13.8±3.6) μmol/L], the difference is statistically significant(t=4.431, P<0.05). The intima-media thickness and carotid plaque area of group B[(1.13±0.16) mm,(19.87±1.82) mm²] were lower than those of group A[(1.19±0.17) mm,(21.79±1.89) mm²], the difference is statistically significant(t=1.685, 4.798, all P<0.05). Conclusion Enalapril maleate folate tablets have ideal therapeutic effect in the treatment of H-type hypertension, can reduce the water pressure and Hcy level of patients, and can improve the results of carotid ultrasonography, the total effective rate of hypotensive effect is high, which is helpful to stabilize patients' condition and promote their early recovery, which is worthy of clinical implementation.