OBJECTIVE: To investigate the relationship between autonomic nervous function and arteriosclerosis in patients with essential hypertension. METHODS: From January 2011 to December 2013, a total of 269 patients with essential hypertension hospitalized in Chang\'an Branch of First People\'s Hospital of Liangshan were divided into normal PWV group (PWV<9 m/s, n=178) and high PWV group (PWV>/=9 m/s, n=91) via the results of carotid-femoral pulse wave velocity (PWV). Synchronic 24 hours ambulatory blood pressure monitoring and dynamic electrocardiogram were performed for all participants to simultaneously monitor the heart rate variability (HRV) and blood pressure variability (BPV) in these patients. Pearson single factor analysis and multivariate logistic regression analysis were performed to define the relationship between PWV and HRV, BPV respectively. RESULTS: The level of nHR/dHR (index of heart rate variability), 24 hour\'sSSD, dSSD, nSSD (indexes of blood pressure variability) increased significantly (all P<0.05), while the level of SDANN (index of heart rate variability) decreased significantly (P<0.05) in high PWV group compared with normal PWV group. Multiple linear regression analysis showed that PWV was positively correlated with 24 hour\'sSSD, 24 hour\'sPP, LF, LF/HF and night/day heart rate ratio (all P<0.05). CONCLUSIONS: HRV (LF, LF/HF, nHR/dHR) and BPV (24 hours\'SSD, dSSD, nSSD) are positively correlated to arteriosclerosis in patients with essential hypertension. Our results show that sympathetic activation and vascular injury are closely related in patients with essential hypertension.