To observe the effect of American ginseng on the serum E-selectin and soluble ICAM-1 levels in elderly hypertensive patients with low diastolic blood pressure. Methods: In the study, 100 elderly hypertensive patients after regular antihypertensive therapy with low diastolic blood pressure, who were older than 65 years old, were randomized into two groups. The 50 patients in American ginseng group received combination therapy of American ginseng and anti-hypertensive drugs; the 50 patients in single drug group received only anti-hypertensive drugs. The sICAM-1 and sE-selectin levels in the patients blood were measured before and after the treatment. Results: The systolic blood pressures in the two groups were reduced after treatment. The American ginseng group showed a greater reduction than the single drug group (P<0.05). The diastolic blood pressures were significantly increased, and pulse pressures were significantly reduced after the treatment in the American ginseng group, which was superior to the single drug group (P<0.01). There was no significant difference in the sICAM-1 and sE-selectin levels between the American ginseng group and the single drug group before the treatment. The sICAM-1 and sE-selectin levels were effectively reduced in the two groups after the treatment, but the American ginseng group showed a greater reduction in the sICAM-1 and sE-selectin levels than the single drug group (P<0.01). Conclusion: The combination therapy of American ginseng and anti-hypertensive drug can effectively treat elderly hypertensive patients with low diastolic blood pressure. It can protect and repair vascular endothelial cells through regulation of adhesion molecules expression and inhibition of inflammatory reaction.