Abstract: Objective To analyze the cardiac function and the adverse outcomes in elderly HFpEF patients with different diastolic blood pressure，and explore the risk factors of death. Methods A total of 207 participants enrolled in this study from March 2015 December 2016 were divided into LDBP group (24 h mean diastolic blood pressure <60 mm Hg, 1 mm Hg=0.133 kPa, n=98) and HDBP group (24 h mean diastolic blood pressure ≥60 mm Hg, n=109). NYHA function classification Ⅲ or Ⅳ, all-cause death, the incidence of non-fatal myocardial infarction and cardiac shock were analyzed. The patients were followed up for 1.5 years with the end point of all-cause death. Risk factors of death were analyzed by Cox regression. Results The severity of cardiac function, mortality, non-fatal myocardial infarction and cardiogenic shock in the LDBP group were higher than those in the HDBP group (all P<0.05). A total of 105 deaths (death group) were observed in 1.5 years of follow-up, and 102 in the survival group. Univariate analysis showed that there were differences in DBP, BMI, COPD, NT-proBNP and IVST levels between the death group and the survival group (all P<0.05). Multivariate Cox regression analysis showed that diastolic blood pressure <60 mm Hg and high IVST level were independent risk factors for death (all P<0.05). Conclusion Low DBP and high IVST increase the risks of death in HFpEF patients.