Objective To explore the relationship between large arterial elasticity and coronary events in patients with hypertension. Methods A total of 252 outpatients with hypertension admitted in Xuanwu Hospital from February 2011 to January 2012 were enrolled in this study. Their large arterial elasticity was assessed by the velocity of pulse wave propagation in the carotid and femoral arteries (cfPWV). All of them were followed up for average 5.5 (5.1 to 5.8) years. The patients were divided into coronary events group (n=25) and non-coronary events group (n=207) according to whether coronary events occurred or not. The differences of baseline data and clinical indices between the 2 groups were analyzed. SPSS statistics 17.0 was used to process the data. According to the data type, Student′s t test, Chi-square test or rank sum test were used for comparison between groups. Logistic regression analysis was carried out for multiple factors. Results In the 252 patients with hypertension, 20 cases were lost during follow-up, and the success rate of follow-up was 92.06%. In the successfully followed-up 232 patients, coronary events occurred in 25 cases. Compared with the non-coronary event group, the coronary event group had significantly older age, higher systolic blood pressure (SBP), more diabetes, and bigger ratio of hypertension (>10 years). They also had higher morbidity of cfPWV [(11.02±2.45) vs (9.27±2.16) m/s, P=0.014]. Multivariate logistic regression analysis showed that cfPWV (OR=2.033,5%CI 1.047-5.536, P=0.012) and diabetes (OR=2.626, 95%CI 1.065-6.471, P=0.032) were independent risk factors of coronary events in hypertensive patients (P<0.05). Conclusion cfPWV and diabetes mellitus have predictive value for coronary events in hypertensive patients and has a certain clinical significance.