ObjectiveHypertension has become the leading cause of death worldwide. Data on hypertension management among Shenzhen elderly are sparse. Our study aims to investigate treated and controlled hypertension in Shenzhen elderly, and identify relevant predictors.DesignA cross-sectional study.SettingCommunities in Shenzhen, Guangdong, China.ParticipantsA cross-sectional study was conducted. We employed a convenience sampling method to select participants; 124 007 participants aged 65 years and older were recruited from January to December 2018 at local community health centres in Shenzhen.Main outcome measuresData on treatment, control and influencing factors of hypertension were obtained from a standard questionnaire, physical measurements and biochemical analyses.ResultsPrevalence of hypertension was 55.8% among the sample population. Among this group of hypertensive patients, those undergoing hypertension treatment and those with hypertension under control were 54.4% and 32.3%, respectively. Employing multivariate analysis, significant associations were found between treatment and older age, junior high school education and above (OR=1.25, p<0.05), being widowed rather than being married or cohabiting (OR=1.28, p<0.05), engaging in physical activity (OR=1.14, p<0.05), ex-smoker (OR=1.19, p<0.05), habitual drinker (OR=0.72, p<0.05), history of cardiovascular disease (CVD) (OR=2.20, p<0.05) and comorbidities, with a higher probability for those with obesity (OR=1.89, p<0.05), central obesity (OR=1.10, p<0.05), diabetes (OR=1.49, p<0.05) or dyslipidaemia (OR=1.20, p<0.05). Male sex (OR=0.91, p<0.05), junior high school education and above (OR=1.28, p<0.05), engaging in physical activity (OR=1.06, p<0.05), history of CVD (OR=1.82, p<0.05) and individuals who had diabetes (OR=1.52, p<0.05) or dyslipidaemia (OR=1.05, p<0.05) were associated with increased likelihood of control. Aged 80 years and older (OR=0.93, p<0.05), habitual drinker (OR=0.73, p<0.05) and central obesity (OR=0.94, p<0.05) were negatively associated with control of hypertension.ConclusionsWe found a high prevalence of hypertension, but a low prevalence of treatment and control among Shenzhen elderly.