Objective To find out the risk factors of obstructive sleep apnea-hypopnea syndrome (OSAHS) with hypertensive and provide guidance for the treatment via retrospective analysis of related clinical indexes.Methods A total of 324 adult patients with OSAHS who underwent polysomnography (PSG) from Jan 2017 to Dec 2021 were enrolled, including 129 patients with concomitant hypertension. Spearman rank correlation coefficient and Logistic model stepwise regression were used to compare and analyze apnea hypoventilation index (AHI), lowest oxygen saturation (LSaO₂), and mean oxygen saturation (MSaO2), oxygen desaturation index, gender, age, disease course, height, weight, body mass index (BMI), smoking history, drinking history, diabetes history, neutrophil/lymphocyte ratio, uric acid, fasting blood glucose, glycated serum protein, low-density lipoprotein, high-density lipoprotein, cholesterol, triglycerides, blood routine, and coagulation function. Their differences between the hypertensive group and non-hypertensive group and correlations with the occurrence of hypertension were compared and analyzed.Results Correlation analysis showed that AHI, age, duration, diabetes history, uric acid, blood glucose, glycosylated serum protein, triglycerides, cholesterol, fibrinogen, body weight, BMI were positively correlated with OSAHS-associated hypertension (P<0.05), while LSaO₂,MSaO₂, prothrombin time, activated partial thromboplastin time were negatively correlated with OSAHS-associated hypertension (P<0.05). There was no obvious correlation between oxygen reduction index, red blood cell count, white blood cell count, and platelet count with OSAHS-associated hypertension (P>0.05). Regression analysis showed that LSaO₂, age, disease course, BMI, glycated serum protein, and prothrombin were risk factors for OSAHS-associated hypertension.Conclusions The prevalence of OSAHS-associated hypertension in the population of OSAHS increases with the increase of the course of the disease. The course of the disease, age, BMI and LSaO₂ are effective indicators for predicting OSAHS-related hypertension, and early warning and intervention should be carried out in the clinical diagnosis and treatment of OSAHS.