Objective Resting heart rate(RHR) symbolizes the sympathetic nerve activity and is correlated with target organ damage in hypertensive subjects. This study aimed to investigate the relation between RHR and the parameters of renal function and other risk factors in elderly hypertensive patients. Methods Totally 419 in-hospital patients from September, 2006 to February, 2011 were enrolled, including 289 males and 130 females, with age ranging from 80～94 years, averaged (80.8±6.1) years. The subjects were divided into three groups according to RHR: group A, RHR＜70 beats/min; group B, RHR 70～80 beats/min; group C, RHR＞80 beats/min. The blood pressure, body mass index(BMI), smoking index(SI) and glycosylated hemoglobin A(HbAc1) were determined. Renal function were evaluated by glomerular filtration rate(GFR) which was determined by Single Photon Emission Computed Tomography(SPECT) , serum creatinine (SCr), creatinine clearance(CCr) and micro albumin uria (MAU) respectively. The relation between RHR and these parameters was identified by simple correlation analysis. Results The RHR was significantly different between the three groups [(63.4±7.2), (74.1±4.0), and (84.3±8.8) beats/min in group A, B and C respectively, P＜0.05], as well as SI [(321±73), (378±99), and (463±79) (cigarettes?year)in group A, B and C respectively, P＜0.05] and SBP [(140.2±10.1), (146.3±8.1) and (149.8±9.6)mmHg in group A, B and C respectively, P＜0.05]. No significant difference was found in age, hypertension course, diabetes and HbAc1 level among the three groups. BMI and DBP were higher in group C than in group A and B[BMI:(23.7±3.0), (23.1±5.4), (25.9±5.9)kg/m2; DBP: (64.6±9.5), (65.2±9.1), (71.3±12.4)mmHg in group A, B, C respectively, P＜0.05]. Significant difference in GFR[(84.5±11.0), (78.2±10.6) and (67.6±10.1)ml/min in group A, B and C respectively, P＜0.05], SCr[(87.3±23.1), (90.0±22.3) and (104.0±19.7)μmol/L in group A, B and C respectively, P＜0.05], CCr[(73.9±16.8), (68.0±18.3) and (62.5±20.1)ml/min in group A, B and C respectively, P＜0.05] and MAU[(51.4±11.3), (56.0±17.3) and (90.9±22.8)mg/L in group A, B and C respectively, P＜0.05] was found among the three groups. RHR was correlated with SBP(r=0.264, P=0.002),GFR(r= ?0.330, P=0.011), CCr (r= ?0.463, P＜0.01) and MAU(r=0.208, P=0.029). Conclusion For elderly hypertensive patients, RHR is correlated with impaired renal function, suggesting that RHR could be regarded as the predictor in renal dysfunction of elderly hypertensive patients.