Objective: As the prevalence of chronic diseases among the elderly increases year by year, chronic renal insufficiency caused by hypertension has become a hot issue of concern to society and even the world. Methods: This article conducted a retrospective analysis of 1856 elderly people over 65 years old, with a follow-up time of 6 years. The aim is to compare the decline in estimated glomerular filtration rate (EGFR) between hypertensive and non-hypertensive populations under non-intervention conditions, and to explore the impact of blood pressure on EGFR in the elderly. Results: The incidence of hypertension among the elderly in this region is significantly higher than the national level. The EGFR value of hypertensive patients is significantly lower than that of non-hypertensive people. There is a difference in the percentage decline in EGFR between hypertensive and non-hypertensive populations under non-intervention conditions, with hypertensive patients experiencing a higher rate of EGFR decline. When blood pressure is lower than 120/80 mmHg, the EGFR decline ratio is lower compared to when blood pressure is higher than 120/80 mmHg. Conclusion: Lowering blood pressure can effectively slow down the decline of EGFR, and the prevalence of hypertension should be reduced.