Objective To investigate the efficacy of various calcium channel blockers combined with folic acid in the treatment of elderly patients with mild to moderate high homocysteine (Hcy) hypertension (H type hypertension). Methods A randomized, single-blind, parallel-controlled trial was carried out on 90 elderly in- and out-patients with mild to moderate primary H type hypertension of grades 1 to 2 in our department from June 2011 to June 2014. They were 42 males and 48 females, and at an age of (66.9±3.5) years. They were randomly assigned into 3 groups (n＝30): group 1 (5mg/d amlodipine), group 2 (2.5mg/d levamlodipine) and group 3 (5mg/d felodipine), all combined with folic acid (0.8mg/d). Blood pressure and serum levels of Hcy, nitric oxide (NO), endothelin-1 (ET-1), superoxide dismutase (SOD) and malondialdehyde (MDA) were measured before and after 4 weeks’ treatment. Results Blood pressure and serum Hcy level were significantly decreased in all 3 groups. Compared to the other 2 groups, amlodipine combined with folic acid had significant effectiveness in lowing both systolic blood pressure and serum Hcy level (P＜0.05). In amlodipine group, the serum levels of NO and SOD were significantly increased, and those of ET-1 and MDA were significantly decreased after treatment (P＜0.05). Conclusion Calcium channel blockers combined with folic acid can reduce both blood pressure and plasma Hcy level in the elderly patients with mild to moderate H type hypertension. The therapeutic scheme of amlodipine combined with folic acid is the best option.