Objective To explore the effect of antihypertensive treatment on target-organ damage in very elderly patients (gt;80 years). Methods One hundred and sixty-seven very elderly hypertensive patients were randomized into two groups, i.e. anti-hypertension treatment group and placebo-control group. All the patients received echocardiographic examination of left ventricular mass index, laboratory tests of urinary creatinine and urinary albumin and 24-hour ambulatory blood pressure monitoring 2 months after placebo washout period and at the end of the one year treatment, respectively. Results After treatment, the improvement in all the dynamic blood pressure parameters except daytime diastolic blood pressure and heart rate(24 h, daytime and night time), were significantly better than that of placebo-control group(Plt;0.05).The improvement in left ventricular and renal functional parameters were significantly better than that of placebo-control group(Plt;0.05). Conclusion Anti-hypertension treatment may significantly improve left ventricular pachynsis and renal function damage in very elderly hypertensive patients.