Abstract: Objective To investigate the characteristics of heart rate variability（HRV）and clinical values in elderly patients with essential hypertension（EH）complicated by coronary heart disease（CHD）. Methods 24-hour dynamic electrocardiogram was performed to examine the HRV in 34 patients with EH,32 patients with EH complicated by CHD,38 old healthy people as an old-aged control group and 51 middle-aged healthy people as a middle-aged control group.Their HRV and incidence of ventricular arrhythmia were comparatively analyzed. Results The HRV was lower in the two patient groups,especially in the group with EH complicated by CHD,than in the two control groups（P＜0.05）.The incidence of ventricular arrhythmia was higher in the two patient groups than in the two control groups（P＜0.01）. Conclusion HRV showing autonomic nerve activity is one of the important indexes for the prognosis of hypertension patients.Other treatment modalities should be considered in addition of hypertension-reducing treatment for such patients,especially for those with EH complicated by CHD in order to improve their autonomic nerve function.