Aim To investigate the correlation between 24-hour ambulatory heart rate (24hAHR) and early renal damage in patients with essential hypertension. Methods A retrospective analysis was conducted on 441 patients with essential hypertension who were admitted to the Department of Cardiology of Shandong Qianfushan Hospital Affiliated to Shandong University from June 2017 to January 2018. Clinical data of the patients were collected and 24-hour ambulatory blood pressure was monitored. The data of 24hAHR, 24-hour average systolic blood pressure (24hSBP), 24-hour average diastolic blood pressure (24hDBP), daytime average heart rate (dHR), daytime average systolic blood pressure (dSBP), daytime average diastolic blood pressure (dDBP), nighttime average heart rate (nHR), nighttime average systolic blood pressure (nSBP) and nighttime average diastolic blood pressure (nDBP) were collected. According to urinary albumin to creatinine ratio (UACR), the patients were divided into non early renal damage group and early renal damage group. The differences of each index were compared between the two groups. The correlation between UACR and each index was analyzed. The risk factors of early renal damage in hypertension were analyzed by Logistic regression.Results The hypertension history, serum creatinine, blood urea nitrogen, 24hSBP, 24hDBP, dSBP, dDBP, nSBP, nDBP, 24hAHR, dHR and nHR in early renal damage group were higher than those in non early renal damage group (all P＜0.05). The proportion of slow heart rate patients in non early renal damage group (80.1%) was higher than that in early renal damage group (66.3%), while the proportion of fast heart rate patients in early renal damage group (33.7%) was higher than that in non early renal damage group (19.9%); The differences were statistically significant (P＜0.05). Correlation analysis showed that UACR was positively correlated with hypertension history, 24hAHR, 24hSBP, 24hDBP, dSBP, dDBP, dHR, nSBP, nDBP, nHR and serum creatinine (P＜0.01). Logistic regression analysis showed that 24hAHR (OR 1.3,5%CI 1.018~1.089, P＝0.003), 24hSBP (OR 1.7,5%CI 1.021~1.053, P＝0.000) and hypertension history (OR 1.9,5%CI 1.015~1.064, P＝0.001) were significantly associated with early renal damage in patients with hypertension, and were the risk factors of early renal damage in hypertension. Conclusion There is a correlation between 24hAHR and early renal damage in hypertension, and fast heart rate is an independent risk factor for early renal damage in hypertension.