Objective To study the structure and function changes of heart in elderly patients with hypertension. Methods Two hundred old patients with hypertension in our hospital were enrolled in this study. Which were divided into elderly aged group (≥ 80 years old, 76 cases) and non-elderly aged group (<80 years, 124 cases). The SBP, DBP, LVDd, VPWd, IVST, LVDs, LAD, EF and FS were compared between the two groups. Results There were no significant differences of SBP and DBP between the two groups(P>0.05). The LVDd, LVDs, and LAD in elderly aged group were higher than that in non-elderly aged group (P<0.05). The LVPWd and IVST in elderly aged group were lower than that in non-elderly aged group (P<0.05). There were no significant differences of EF and FS between the two groups (P>0.05). Conclusion The cardiac structural changes are more early than function changes in elderly hy-pertensive patients.