Objective To investigate the epidemiological risk factors profile for cardiovascular and metabolic diseases among the over-80-year-old community residents. Methods Stratified random sampling was used in this survey conducted from May 2013 to October 2015. Totally 2254 elderly residents (≥80 years old) were subjected from 44 communities. Field questionnaire survey, physical examination, electrocardiography and blood biochemical assays were carried out, with a response rate of 90.6%. All participants were divided into male group (n=1122) and female group (n=1132). Results The prevalence of smoking and drinking was 11.2% and 8.4%, respectively in the subjects, with that of the male group significantly higher than in the female (P<0.05). Hypertension was quite common in the participants, and only 6.6% of them had normal blood pressure. There were more males having impaired fasting glucose, elevated serum creatinine and arrhythmia, but they had lower prevalence of hyperuricemia, obesity, and increased non-high-density lipoprotein cholesterol when compared with the females (P<0.05). The subjects had their systolic blood pressure (SBP) and pulse pressure (PP) higher than the normal values, and their heart rate (HR), waist circumference, total cholesterol (TC) and serum creatinine (Scr) were closed to the critical values, and their body mass index (BMI), triglycerides (TG), serum uric acid and diastolic blood pressure (DBP) were in the normal ranges. The female group had significantly higher SBP, PP, heart rate, waist-to-height ratio, TG, TC, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and non-HDL-C, and obviously lower DBP, fasting blood glucose, serum uric acid, Scr and glomerular filtration rate when compared with the male group (all P<0.05).Conclusion Hypertension is quite common in the elderly aged 80 and older. Their many indicators are close to the critical values or even higher than normal values, indicating that there are individual differences among the population, and individualized treatment is needed.