Objective To explore the relationship between the polymorphism of apolipoprotein H gene（ApoH) and hypertensive renal injury and renal substantial hypertension. Methods Ninety-six patients with hypertension and normal renal function（EH-NRF）、92 with hypertension and renal failure(EH-CRF)、104 with renal substantial hypertension and normal renal function(RH-NRF)、112 with renal substantial hypertension and renal failure(RH-CRF)and 100 normal controls(NC) in Heilongjiang province were detected by PCR-single strand conformation polymorphism (PCR-SSCP). Results G341A(Ser88Asn) in the third of ApoH in the Hans in Heilongjiang are polymorphic. The polymorphic A allele of G341A(Ser88Asn) in EH-NRF and EH-CRF occurs more frequently than that in RH-NRF、RH-CRF and NC（P<0.05,P<0.01）; The frequency of A allele in EH-CRF is higher than EH-NRF (P<0.05); there is no significant difference in allece frequency between RH-NRF、RH-CRF and NC. Conclusions The polymorphic A allele in G341A(Ser88Asn) may be the genetic risk to hypertension in the Hans in Heilongjiang, but this polymorphism of ApoH is not reasonable to explain renal hypertension, which suggests that there exist different genetic background between hypertension with uremia and uremia with hypertension