Geriatric hypertension is one of the common chronic cardiovascular diseases of the elderly, with its own characteristics, is a special type of hypertension, the course of the disease is mostly long, the disease progresses slowly. Because the elderly have a high tolerance to the gradually increasing blood pressure, the clinical symptoms are not obvious, which can easily cause the delay of the disease, and at the same time, the disease has a variety of serious complications such as cerebral hemorrhage, cerebral thrombosis, cerebral embolism, heart failure, renal failure, etc. The incidence is also increasing, and the morbidity and mortality rate is extremely high, so it is of great significance to strengthen the prevention and treatment of hypertension in the elderly. 1, the onset of hypertension in the elderly characteristics (1) a long course, the onset of insidious. Most of the course of the disease is more than a dozen years to decades, the progress is slow, and because the elderly organism has a higher tolerance for elevated blood pressure, so the symptoms are not typical, and even many patients to the emergence of complications as the first symptom of the diagnosis, resulting in the delay of the disease. (2) Most of the patients have increased systolic blood pressure and increased pulse pressure. Due to the atherosclerosis of large arteries, the elasticity decreases, the diameter of the surrounding small vessels becomes smaller, the peripheral circulation pressure increases, and simple systolic hypertension appears. (3) Large range of blood pressure fluctuations, abnormal circadian rhythm, more likely to occur postural hypotension combined with morning peak hypertension. It may also be manifested as less than 10% drop in blood pressure at night or a significant drop in blood pressure after meals. In addition, although the chance of occurrence of simple systolic hypertension is not high, it will aggravate the stiffness of the large arteries and further increase the pulse pressure difference, thus making it more harmful, which is also an important feature of hypertension in the elderly. (4) There are many target organ complications, such as stroke, coronary heart disease, renal failure, diabetes mellitus, hyperlipidemia and other serious complications, and the condition is critical, and the morbidity and mortality rate is high. (5) Reduced β-receptor sensitivity and sympathetic nerve activity, therefore, the efficacy of β-blockers is diminished in all elderly hypertensive patients. (6) Left ventricular hypertrophy: According to the Framingham study, the incidence of sudden death and myocardial infarction in elderly hypertensive patients with left ventricular hypertrophy is five times higher than that in those without left ventricular hypertrophy. And reversal of left ventricular hypertrophy can improve the natural course of hypertension and coronary heart disease, which is of great significance to the treatment of hypertension. 2, elderly hypertension treatment countermeasures should follow the principle of rational drug use, small dose administration, slow increment, individualized drug use, and avoid abrupt discontinuation of drugs, which may lead to blood pressure rebound. In the absence of risk factors and target organ damage, non-pharmacological treatment is preferred, and blood pressure is controlled through diet adjustment and moderate exercise. If blood pressure control is still unsatisfactory after 2 to 3 months, drug therapy should be given; patients with risk factors and target organ damage should be treated with drugs early. First, choose a single type of drug, starting with a small dose, closely observe the efficacy and adverse reactions, and adjust at any time. The use of drug combination antihypertensive therapy is conducive to the reduction of blood pressure to normal in a relatively short period of time and can reduce the occurrence of adverse drug reactions, and the selection of drugs should pay attention to the use of different mechanisms of antihypertensive drugs, the combination of diuretics and several other drugs can be used to enhance the efficacy, but need to pay attention to its impact on the metabolism of potassium, blood glucose, blood lipids and blood uric acid. The combination of diuretics and β-blockers, diuretics and ACEI or ARB, and the combination of calcium antagonists and β-blockers, ACEI or ARB are the most commonly used antihypertensive programs. The purpose of lowering blood pressure. For elderly patients with high pulse pressure and fluctuating blood pressure, antihypertensive drugs that reduce arterial stiffness and improve the elasticity of large arteries can be chosen as the treatment strategy. In addition to ACEI, ARB, diuretics, and CCB, nitrates are effective in reducing the pulse pressure difference. The treatment of partially uncontrolled non-arrythmic hypertension can be achieved by taking antihypertensive drugs at night before bedtime to lower blood pressure smoothly. In the treatment of this disease, risk factors such as target organ damage and complications should be taken into consideration, and the ultimate goal is to reduce the incidence of cardiovascular and cerebrovascular diseases and mortality, and the goal of blood pressure lowering should be, in principle, to the maximum tolerable level of the patient. The 2011 “Expert Consensus on Hypertension in the Elderly” published by the American College of Cardiology Foundation (ACCF) in conjunction with the American Heart Association (AHA) recommends controlling systolic blood pressure to 140-145 mmHg (if tolerated) and avoiding SBP <130 mmHg and DBP <65 mmHg in patients older than 80 years.