OBJECTIVE：To observe the efficacy and safety of nifedipine combined with hydrochlorothiazide in the treatment of elderly patients with hypertension. METHODS： 76 elder patients with hypertension were randomly divided into observation group and control group. After 3 d of antihypertensive drugs withdrawal in all patients， control group was orally treated with one tablet Nifedipine sustained release tablet， twice a day； observation group was additionally given one tablet Hydrochlorothiazide tablet， once a day. 1 course included 8 weeks， and it lasted 2 courses. Clinical efficacy， mean sitting diastolic blood pressure （DBP）， mean sitting systolic blood pressure （SBP）， renal functions （serum potassium， serum creatinine， uric acid， microalbuminuria， blood urea nitrogen） before and after treatment， and the incidence of adverse reactions in 2 groups were observed. RESULTS： The total effective rate in observation group was significantly higher than control group， the incidence of adverse reactions was significantly lower than control group， the differences were statistically significant （P＜0.05）. Before treatment， there were no significant differences in the mean sitting DBP， mean sitting SBP and renal functions between 2 groups （P＞0.05）； after treatment， the mean sitting DBP， mean sitting SBP， serum creatinine and blood urea nitrogen in 2 groups were significantly lower than before， and observation group was lower than control group， the differences were statistically significant （P＜0.05）， and there were no significant difference in the serum potassium， uric acid and microalbuminuria before and after treatment（P＞0.05）. CONCLUSIONS： Nifedipine combined with hydrochlorothiazide has significant efficacy in the treatment of senile hypertension， and it can effectively reduce DBP and SBP， and improve renal function indicators， with good safety.