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AIM To explore the association between morning blood pressure surge and cognitive function in elderly patients with essential hypertension.METHODS 107 patients submitted to 24h ambulatory blood pressure monitoring were categorized as with MBPS(n=40), and NMBPS(n=67).Total cholesterol, body mass index(BMI) were determined, and MMSE was measured.RESULTS BPS in MBPS was higher than that in NMBPS(P<0.05).MMSE in MBPS was lower than that in NMBPS (25.98±2.03 vs 28.86±-1.81, P<0.01).CONCLUSION Morning blood pressure surge is closely related with the cognitive impairment in elderly patients with essential hypertension.