Background: Coping, an essential intermediary variable of psychological stress, may affect the process of disease, and alongside family function, has also been linked to patient quality of life. However, these have not yet been investigated in older adults with hypertension. Objective: To investigate the correlation between medical coping modes and family function, and the associated factors among older adults with hypertension in China. Methods: This cross-sectional study included 341 patients (135 men, 206 women) with a mean age of 75.16. Participants were recruited from three hospitals in China, the Medical Coping Modes Questionnaire and the Family APGAR Index Scale were used to collect dada. Data were analyzed using Pearson correlation and multiple linear regression analysis in SPSS 26.0. Results: Medical coping ability included three dimensions: Confrontation (19.42±3.83), avoidance (14.37±3.02), acceptance– resignation (9.19±2.09), and family function (7.47±1.47) were insufficient in older adults with hypertension; further, family function was positively correlated with the confrontation dimension (p<0.05), and negatively correlated with the acceptance– resignation dimension (p<0.05). Conclusion: Improving family function among older adults with hypertension could enhance confrontation and reduce acceptance–resignation. Family-centered intervention measures may assist in promoting coping ability and healthy behaviors among older adults with hypertension.