Abstract: AIM: To analyze the relation between cognitive functions and different levels of blood pressure achieved after treatment and to explore the influential factors of cognitive impairment in elderly hypertensive patients.METHODS: Included in the study were 105 elderly hypertensive patients who received antihypertensive drug treatment for(12±7) years.Cognitive functions were evaluated with Mini-Mental State Examination Scale(MMSE).According to MMSE scores,all subjects were divided into cognitive impaired group(n=48) and normal cognitive group(n=57).RESULTS: Significant differences were found in the duration of hypertension and plasma homocysteine levels between cognitive impaired group and normal cognitive group.Using multivariate analysis of covariance adjusting for the duration of the hypertension,MMSE scores of patients who achieved the goal SBP of 111-129 mmHg were 14.94±10.28,respectively,22.97±7.30 in 130-149 mmHg group and 20.61±8.59 in the 150-160 mmHg group.Significant differences were observed in MMSE scores in 130-149 mmHg group compared with those in 111-129 mmHg group and 150-160 mmHg group(P<0.01).No significant difference was found in diastolic blood pressure levels.CONCLUSION: Antihypertensive therapy may better protect cognitive functions in elderly hypertensive patients if SBP can be maintained at 130-150 mmHg.