To observe the effect of Yiqi Huoxue Recipe(YQHX) combined with enalapril on vascular endothelial function in elderly patients with essential hypertension.Methods:A total of 120 elderly patients with grade Ⅰ essential hypertension who were admitted to Shanghai Seventh People's Hospital from October 2017 to December 2020 were selected and randomly assigned into a Chinese medicine group(YQHX)，an integrated Chinese and western group(YQHX+enalapril)，and a western medicine group(enalapril)(n=40) according to the random number table method.All the patients received diet，exercise，and basic therapy(blood pressure-lowering，lipid-lowering，and antiplatelet therapy).Each course of the treatment was 12 weeks.The levels of endothelin-1(ET-1)，angiotensin Ⅱ(AngⅡ)，interleukin-6(IL-6)，C-reactive protein(CRP)，tissue-type plasminogen activator(t-PA)，plasminogen activator inhibitor-1(PAI-1)，and flow-mediated dilation(FMD) were compared among the three groups.Results:The therapeutic effects on blood pressure of the integrated Chinese and western medicine group，the Chinese medicine group，and the western medicine group were 95%，92.5%，and 90%，respectively，which showed no statistical significance between each other(P>0.05).The effective rates for TCM syndromes in the three groups were 87.5%，75%，and 62.5%，respectively，and the integrated group outperformed the western medicine group(Z=6.667，P=0.010).The integrated group outperformed the Chinese medicine group in the down-regulation of ET-1，IL-6，CRP，and PAI-1 and the improvement of FMD(P<0.05)，and it was superior to the western medicine group in the down-regulation of AngⅡ and CRP(P<0.05).Conclusion:YQHX combined with enalapril can improve the vascular endothelial function in elderly hypertensive patients by down-regulating the expression of ET-1，AngⅡ，IL-6，CRP，and PAI-1，up-regulating the expression of t-PA，and increasing FMD.Therefore，this therapy is worth popularizing in elderly hypertensive patients.