Objective To assess the clustering of cardiovascular risk factors and their effects on target organ damage in elderly patients with hypertension .Methods 421 treated elderly hypertension patients were divided into 5 groups based on the number of risk factors :hypertension without additional risk factor (group A ,25 cases) ,and the other 4 groups were complicated with 1 (group B ,76 cases) ,2(group C ,127 cases) ,3(group D ,128 cases)and ≥ 4 (group E ,65 cases) risk factors .The structure and function of heart and carotid artery were examined by ultrasonography in order to evaluate the damage of target organ and the morbidity .Re-sults The patient groups with three or more risk factors showed significantly higher levels of BMI ,plasma glucose ,triglyceride , LDL-C cholesterol ,serum creatinine and serum uric acid ,and needed greater number of antihypertensive drugs ,compared with other groups(P<0 .05) .The patient groups with two or more risk factors showed significantly higher levels of LVMI ,IMT and MAU/Cr compared with group A(P<0 .05) ,and significantly lower levels of the creatinine clearance (P<0 .05) .In addition ,they showed significantly higher incidences of coronary heart disease and cerebrovascular disease and chronic kidney disease compared with group A (P<0 .05) .Conclusion These results suggest that the hypertensive patients with clustering risk factors required greater number of antihypertensive drugs .The more additional risk factors exit ,the more target organ damages and higher morbidity occur ,and more intensive intervension are required to control not only blood pressure but also other complicated risk factors .