Abstract: Objective To analyze the correlation between depression and different time points blood pressure in elderly patients with essential hypertension. Methods Total 90 elderly patients with essential hypertension who visited our hospital from May 2018 to August 2019 were selected as the research subjects. The ratio of male to female was 1:1, and the average age was (66.2±4.3) years. The patient's 24 h ambulatory blood pressure was monitored. Patients were screened for depressive symptoms according to the Hamilton Depression Scale (HAMD), and divided into depression groups (n=52, depression score ≥ 7) and control group (n=38, depression score<7) based on quantitative assessment. The blood pressure, depression degree, and laboratory tests were compared between two groups. Results There was no significant difference in mean systolic and diastolic blood pressure in daytime, mean systolic and diastolic blood pressure at night, and prevalence of non dipper type blood pressure in the 24-hour mean blood pressure between the two groups (all P>0.05). The morning peak of blood pressure in the depression group[(29.58±3.36) mm Hg] was significantly higher than that in the control group[(16.12±3.67) mm Hg, P<0.05]. The morning peak of blood pressure in the depression group was significantly higher than that in the control group (P<0.05). The correlation analysis showed that the patient's depression level was positively correlated with the morning blood pressure peak, and the regression equation was Y=17.830+0.192X, which was statistically significant (r=0.387, P<0.01). Conclusion There is a correlation between the depression of elderly essential hypertension patients and their morning blood pressure peaks, which should be paid attention in clinical diagnosis and treatment to improve the treatment effect of patients.