Objective: To evaluate the effects of dexmedetomidine on cardiovascular response during anesthetic induction and endotracheal intubation in hypertensive patients. Interventions: This was a prospective, double-blind, and placebo controlled study. Patients with preoperative diagnosed and well controlled hypertension were enrolled and randomly divided into dexmedetomidinegroup(group D)and control group(group C). Dexmedetomidine (an initial dose of 1.0 μg/kg for 10 min, followed by a continuous infusion of 0.7 μg/kg/h) or normal saline was administered 25 minutes before anesthetic induction. Anesthesia was induced with sufentanil, propofol, and rocuronium. BIS was maintained from 40 to 60. Hemodynamic parameters including systolic (SBP) and diastolic blood pressures (DBP), and heart rate (HR) were measured and the percent changes were calculated during both anesthetic induction and intubation. Results: After administration of experimental drugs,SBP and HR were significantly lower in the treatment group than in the control group [(139.1 ± 23.9) mm Hg vs. (165.2 ± 18.3 )mm Hg, P<0.001 and (63.8 ± 11.3) bpm vs. (77.2 ± 13.0) bpm, P=0.001, respectively]. Before insertion of the laryngoscopy, the percentage decreased in SBP and DBP were significantly less in the treatment group than in the control group [(-14.6± 9.6)% vs. (-34.5± 10.7)%, P<0.001 and (-7.2± 9.6)% vs. (-28.7± 12.0)%, P<0.001, respectively]. One minute after endotracheal intubation, SBP, DBP, and HR were significantly lower in the treatment group than that in the control group [SBP: (134.0 ± 25.8) mm Hg vs. (171.6 ± 30.0) mm Hg, P<0.001; DBP: (78.1 ± 17.7) mm Hg vs. (93.3 ± 17.5) mm Hg, P=0.009; and HR: (71.1 ± 11.0) bpm vs.（91.1 ± 14.0 ）bpm, P<0.001, respectively】. Conclusion: Dexmedetomidine combined with propofol and sufentanil suppressed the decrease in blood pressure due to anesthetic induction and blunted the cardiovascular response to endotracheal intubation in hypertensive patients.