Objective To survey the nutritional status of elderly hospitalized patients with hyper-tension and frailty,and explore the correlation between nutrition and frailty.Methods A total of 801 elderly hypertensive patients admitted to our hospital from October 2022 to December 2023 were cosecutively enrolled,and according to Fried frailty phenotype criteria,they were divided into frailty group(score:≥3,276 cases),pre-frailty group(score:1-3,362 cases)and non-frailty group(score:0,163 cases).At the same time,MNA was used to evaluate the nutritional risk of the patients,and the scores of ADL and the score of ACCI were recorded.Logistic regression mod-el was used to analyze the influencing factors of frailty in elderly hypertensive patients,Spearman correlation analysis was employed to analyze the relationship between frailty and nutrition-related indicators,and ROC curve was plotted to analyze the predictive performance of these nutritional indicators in the occurrence of frailty.Results There were statistically differences among the three groups in terms of age,mean SBP,complication of other chronic diseases,polypharmacy,mean handgrip strength,calf circumference,MNA score and classification,ADL and ACCI scores,and levels of hemoglobin,HDL-C,LDL-C,TC,albumin,25-hydroxyvitamin D[25(OH)D],bone alkaline phosphatase,VitB12 and Hcy(P＜0.05,P＜0.01).Multivariate logistic regression analysis revealed that polypharmacy(OR=2.361,95％CI:1.332-4.183),MNA score ≥24(OR=0.298,95％CI:0.110-0.808),ADL score(OR=1.094,95％CI:1.028-1.166),albumin(OR=0.963,95％CI:0.934-0.994),and 25(OH)D(OR=0.989,95％CI:0.980-0.998)were independent risk factors for frailty in elderly hypertensive patients(P＜0.05,P＜0.01).Frailty was positively cor-related with age,polypharmacy,other chronic diseases,and ACCI score(P＜0.01),and negatively with MNA score,MNA classification,hemoglobin,albumin,25(OH)D,HDL-C,LDL-C,Hcy,average grip strength,and calf circumference(P＜0.01).ROC curve analysis showed that the AUC values of 25(OH)D,albumin,and MNA score were 0.607,0.588,and 0.700,separately.Con-clusion Elderly patients with hypertension and frailty have poor nutritional status,and identify-ing early frailty relies on nutritional risk assessment.Frail patients have a high risk of malnutri-tion and are influenced by various factors.Among them,albumin,MNA score,and 25(OH)D can effectively predict the occurrence of frailty in elderly hospitalized hypertensive patients,with MNA score having stronger predictive performance.