Abstract: Objective To understand the current status of the use of antihypertensive drugs as well as the inconsistency between medication and recommendation of China guideline on hypertension in community hypertensive patients. Methods Based on “CAMS Innovation Fund for Medical Science” program, subjects with hypertension or at high risk of coronary heart disease from 25 districts and counties nationwide were included from August 2018 to December 2020. Basic information of subjects and data（names, doses and frequency of antihypertensive drugs） were collected. Information on the frequency, combination patterns of different antihypertensive drugs, and the inconsistency between antihypertensive medication and guideline recommendation were analyzed. Results A total of 4 518 subjects with hypertension were included in the study mean age（61.7±9.4） years, 45.2% were male. Among 2 930 hypertensive patients taking medication, 68.3% were on monotherapy. Calcium channel blockers（CCB, 59.2%） was the most frequently used antihypertensive drug in patients with single drug therapy, while angiotensin receptor blockers combined with CCB were the most common（24.7%） in combination therapy. Medications were inconsistent with the guideline recommendation in 5.3% of patients. Conclusion The hypertensive patients are mainly treated with single durg in China primary community outpatient clinics, and the inconsistency between antihypertensive drugs use and guideline recommendation still exist.