Objective: To explore the effect of pathway nursing in the treatment of H-type hypertension with heart failure with preserved ejection fraction (HFPEF). Methods: All 100 patients with H-type hypertension and HFPEF admitted to the Department of Cardiology of the First Hospital of Qinhuangdao City from January 2015 to August 2016 were selected as a control group, and routine nursing was adopted. All 100 patients with H-type hypertension complicated with HFPEF from September 2016 to January 2019 were selected as an observation group, and pathway nursing was adopted. Health knowledge, blood pressure, left atrial volume/body surface area (LAVI) and other indicators were compared between the 2 groups. Results: The awareness rate of health knowledge and the importance of removing high-risk factors in the observation group were higher than those in the control group, with statistical significance (P<0.05). The systolic and diastolic blood pressures of the observation group were lower than those of the control group, and the LAVI was lower than that of the control group (P<0.05). After intervention, Hcy in the observation group was lower than that in the control group and N-terminal pro-brain natriuretic peptide (NT-proBNP) was lower than that in the control group (P<0.05). Conclusion: Pathway nursing can improve the understanding of H-type hypertension patients with HFPEF on their own diseases, the level of blood pressure control, and the left atrial pumping function.