Objective To determine the risk factors for heart failure with preserved ejection fraction (HFpEF) in the elderly by retrospectively analyzing their clinical features and echocardiographic parameters of HFpEF patients and comparing with those of non-heart failure patients with asymptomatic diastolic dysfunction. Methods A total of 234 consecutive patients (≥60 years old) admitted in our department from December 2011 to December 2012 were enrolled in this study. They were divided into asymptomatic left ventricular diastolic dysfunction group (ADD group, n＝104) and HFpEF group (n＝130). Risk factors of HFpEF were analyzed by logistic regression. Results Compared with ADD group, the patients in HFpEF group were older and had a lower estimated glomerular filtration rate (eGFR) (P＜0.05). Logistic regression analysis indicated that coronary artery disease(CAD), hypertension, and chronic obstructive pulmonary disease (COPD) were independent risk factors of HFpEF (P＝0.001, 0.031, 0.003, respectively). Conclusion CAD, hypertension and COPD are associated with HFpEF in this cohort.