Objective To compare the efficacy and safety of compound reserpine triamterene tablets (No.0) with other anti-hypertensive drugs for the treatment of the elderly hypertensive patients. Methods From August 2018 to December 2018, a total of 1574 elderly hypertensive patients were recruited for the study from 26 community health service centers in 10 municipalities or provinces, namely, Tianjin, Henan, Anhui, Shandong, Jiangsu, Shanxi, Sichuan, Liaoning, Beijing, and Hebei. They were divided into No.0 group who took No. 0 (matched by an age difference ≤ 5 years and gender with a ratio of 1∶1) and Non-No.0 group who did not, with 787 patients in each. Of all the patients, 186 at advanced age (≥80 years) were divided into 2 sub-groups:aged No.0 subgroup (n=102) and aged non-No.0 subgroup (n=84). The two groups were compared in clinical data and the two sub-groups were compared in terms of the lab findings and mental status scores. Statistical analysis was performed using SPSS statistics 22.0. Results No significant difference was observed in hypertension grade and blood pressure on visits between the two groups (P>0.05). The No.0 group took significantly fewer anti-hypertensive tablets daily than the non-No.0 group [(1.33±0.63) vs (1.41±0.63) pills,P<0.05]; similarly, the former group took significantly less calcium channel blocker (CCB) (16.39% vs 70.14%), angiotensin converting enzyme inhibitors (ACEI) (4.07% vs 11.82%), angiotensin receptor blocker (ARB) (9.53% vs 34.18%), beta blockers (4.32% vs 13.09%) or diuretics (1.65% vs 6.86%) than the non-No.0 group (P<0.05). In terms of safety, there was no statistically significant difference between the 2 groups and the two sub-groups at advanced age in white blood cell, hemoglobin, platelets, liver function, renal function, fasting plasma glucose, serum lipid, depression and anxiety score (P>0.05). Conclusion Compound reserpine triamterene tablets have anti-hypertensive effect in the elderly patients with good safety, reducing the number of tablets taken daily and improve patient compliance.