Background Hypertension associated with hyperhomocysteinemia(HHcy) is defined as H-type hypertension.Hypertension and HHcy has a strong synergy that could lead to the risk of vascular disease, such as carotid remodeling. However, the relation of inflammatory factors and adhesion molecule with carotid remodeling in H-type hypertension is unknown. Methods Fifty-six patients with H-type hypertension and 52 without hyperhomocysteinemia hypertension were enrolled in this study, with 42 healthy volunteers as the control group. All the subjects underwent color Doppler ultrasound examination of carotid artery. The expression of ICAM-1 in peripheral blood monocytes was measured by direct immunofluorescence technique in combination with flow cytometry. The levels of high sensitivity C-reactive protein(hs-CRP), Monocyte chemoattractant protein-1(MCP-1) and s ICAM-1 were measured. The correlations between carotid vascular remodeling and these biomarkers were analyzed. Results The intima-media thickness(IMT), circulating levels of hs-CRP and MCP-1, and monocyte ICAM-1 were significantly increased in H-type hypertension group(P < 0.05). There were no significant difference in those measurements between the simple hypertension group and the control group(P > 0.05). The levels of s ICAM-1 showed no significance among the three groups(P > 0.05). Correlation analyses revealed a positive correlation of carotid plaque index with homocysteine, hs-CRPand MCP-1,and the expression of ICAM-1 in the monocytes in the H-type hypertension group. Multivariate logistic regression analysis revealed that Hcy and hs-CRP were the independent risk factors of IMT in the H-type hypertension group. Conclusion The patients with H-type hypertension are more likely to have carotid vascular remodeling with higher levels of inflammation and adhesion molecules which might lead to the development of atherosclerosis. Background Hypertension associated with hyperhomocysteinemia (HHcy) is defined as H-type hypertension. Hypertension and HHcy has a strong synergy that could lead to the risk of vascular disease, such as carotid remodeling. However, the relation of inflammatory factors and adhesion molecule with carotid Methods Fifty-six patients with H-type hypertension and 52 without hyperhomocysteinemia hypertension were enrolled in this study, with 42 healthy volunteers as the control group. All the subjects underwent color Doppler ultrasound examination of carotid artery . The expression of ICAM-1 in peripheral blood monocytes was measured by direct immunofluorescence technique in combination with flow cytometry. The levels of high sensitivity C-reactive protein (hs-CRP), Monocyte chemoattractant protein-1 (MCP- The correlations between carotid vascular remodeling and these biomarkers were analyzed. Results The intima-media thic There was no significant difference in those measurements between the simple hypertension group and kappa (IMT), circulating levels of hs-CRP and MCP-1, and monocyte ICAM-1 were significantly increased in H-type hypertension group the levels of s ICAM-1 showed no difference among the three groups (P> 0.05). Correlation analyzes revealed a positive correlation of carotid plaque index with homocysteine, hs-CRP and MCP-1, and the expression of ICAM-1 in the monocytes in the H-type hypertension group. Multivariate logistic regression analysis revealed that Hcy and hs-CRP were the independent risk factors of IMT in the H-type hypertension group. hypertension are more likely to have carotid vascular remodeling with higher levels of inflammation and adhesion molecules which might lead to the development of atherosclerosis.