Objective? To investigate the efficacy of Amiodarone combined with Valsartan in the treatment of hypertension complicated with paroxysmal atrial fibrillation, and its effect on blood pressure and cardiac function. Methods 190 patients with hypertension complicated with paroxysmal atrial fibrillation who were treated in The Thirteenth People’s Hospital of Chongqing from April 2019 to February 2021 were divided into two groups by random number table, with 95 cases in each group. Patients in the control group were treated with Amiodarone combined with Enalapril, and patients in the observation group were treated with Amiodarone combined with Valsartan, both groups were treated for 6 months. The maintenance rate of sinus rhythm 1, 3 and 6 months after treatment, blood pressure index, atrial fibrillation attack status, cardiac function index before and after treatment were compared between the two groups. Results The maintenance rate of sinus rhythm in the observation group was significantly higher than that in the control group 1, 3 and 6 months after treatment; compared with before treatment, the systolic and diastolic blood pressure of the two groups decreased significantly after treatment (all P<0.05), but there was no significant difference between the two groups (allP>0.05); compared with before treatment, the ventricular rate and the number of atrial fibrillation attacks in the two groups were significantly less after treatment, and the observation group was significantly less than the control group, the duration of atrial fibrillation attack was significantly shorter, and the observation group was significantly shorter than the control group; after treatment, left ventricular ejection fraction (LVEF) of the two groups were significantly higher, and the observation group was significantly higher than the control group; P wave maximum time limit (Pmax) and P wave dispersion (Pd) in the two groups were significantly lower, and the observation group was significantly lower than those in the control group (allP<0.05). Conclusion? Compared with Amiodarone combined with Enalapril, Amiodarone combined with Valsartan in the treatment of hypertension complicated with paroxysmal atrial fibrillation can not only reduce blood pressure, but also improve patients' cardiac function, inhibit atrial tissue and electrical remodeling, maintain patients' sinus rhythm.