Objective: Studies of factors associated with symptoms of depression in the elderly in China are scarce, especially for those with hypertension residing at home in the general population. Methods: We conducted a cross-sectional study to determine the risk factors for depression in a hypertensive population residing in Beijing in 2004. The sample population consisted of 1064 people aged >= 60 years dwelling in an urban district, a suburb, and in mountain country. Statistical sampling techniques included cluster, stratification, and random selection. Trained staff using a comprehensive geriatric assessment questionnaire, a standard survey instrument in China, completed the assessments. During person-to-person interviews, data were collected regarding demographic characteristics and living and health conditions. Results: Symptoms of depression were scored according to the Center for Epidemiologic Studies-Depression (CES-D) screening test. We showed that factors that were associated with a higher incidence of depression were living in a rural area, being illiterate, without a mate, low income, experiencing a significant stressful life event, poor sleep pattern, poor functional status, and poor cognitive function. Logistic regression analysis indicated that elderly participants with hypertension were significantly more likely to develop depression symptoms under conditions of illiteracy, experiencing a significant stressful life event, poor sleep habits, and poor functional status. Conclusions: Our study determined risk factors for depression in elderly patient with hypertension, and these risk factors are modifiable. This indicates that depression in these patients can be prevented by appropriate lifestyle changes and psychological health education.