Abstract: Objective To explore the effects of hypertension and the number of combined chronic diseases on the risk of impaired daily activities（ADL） in Chinese elderly. Methods Survey data of 10 563 elderly people without ADL impairments recruited by the Chinese longitudinal healthy longevity survey（CLHLS） in 2002 was used as baseline data, which included the individual characteristics of the elderly and hypertension and the number of combined chronic diseases. These data were then divided into 6 groups: no chronic disease, 1 chronic disease（excepted of hypertension） group, ≥2 chronic diseases, hypertension only, hypertension combined with one chronic disease, hypertension combined with ≥2 chronic diseases. The ADL were followed up every 3 years in 2005, 2008, 2011 and 2014. Cox proportional hazard model was used to estimate the hazards ratios（HR） for the associations between hypertension and the risk of ADL impairment. Results Among the 10 563 elderly people, 1 577（14.92%） had hypertension at the baseline survey. At the end of the follow-up, 2 131（20.17%） had ADL impairment, and the cumulative probability of well ADL was 40.03%. After adjusting for the effects of confounding factors, compared with the elderly without chronic diseases, the risk of ADL impairment was increased by 38%（HR=1.38, 95% CI 1.14-1.68） in hypertension only group, 42%（HR=1.42, 95% CI 1.17-1.71） in hypertension combined with 1 chronic disease group, 54%（HR=1.54, 95% CI 1.28-1.86） in hypertension combined with ≥2 chronic diseases group. The piecewise linear regression coefficient of dose response was 0.09（P＜0.001）. Conclusion Hypertension is an important risk factor for the impairment of ADL in the elderly. With the increase of the number of combined chronic diseases, the risk of ADL impairment increased gradually.