Systemic Arterial Hypertension (SAH) is characterized by high levels of blood pressure in the arterial vessels. Orem's theory of self-care has become an important tool for the prevention of diseases and reduction of morbidity and mortality due to this cause, considering the extrinsic and modifiable factors of the disease. This study aims to reflect on the nursing care of hypertensive elderly people, based on Orem's theory of self-care. This is a study with a qualitative and descriptive approach, theoretical-reflective, from the perspective of Dorothea Orem's theory of self-care. The SciELO library, BDTD and BDENF databases were used. The search period was from February to May 2022, with time delimitation from 2017 to 2022. To guide the search, the DeCS/MeSH were applied: ¬"Nursing Theory OR (Health of the Elderly AND Hypertension OR Nursing Theory" in SciELO and "Nursing Care" OR "Elderly" AND "Nursing Theory" AND "Aging" in BDENF and BDTD, associated with the Boolean operators AND and OR. According to the eligibility criteria, 27 articles were included in this theoretical-reflective study. Orem considers self-care, the execution of actions that the individual initiates and executes in his own interest, in order to maintain life, stay healthy and in function of well-being. Therefore, to make a difference in nursing care to the elderly with SAH, it is essential to connect knowledge from nursing theories, research and clinical practice. As well as, to reflect on the practice of self-care by the elderly, understanding whether it is necessary to intensify the development of research on the subject investigated.