Eligibility CriteriaInclusion criteria:
- Hypertensive patients aged 60 years or older.
- SBP>= 150 mmHg but <180 mmHg, if currently (within the previous two weeks) not regularly treated with antihypertensive drugs.
- If currently (at least 10 days on medications within the previous two weeks) regularly treated with antihypertensive drugs, blood pressure must meet the following criteria:
SBP >= 140 mmHg but <170 mmHg, if regularly (no less than 10 days) taking 1 type of antihypertensive medication within the previous two weeks; SBP >= 130 mmHg but <160 mmHg, if regularly (no less than 10 days) taking 2 types of antihypertensive medications within the previous two weeks; SBP >= 130 mmHg but <150 mmHg, if regularly (no less than 10 days) taking 3 types of antihypertensive medication within the previous two weeks.
For patients taking a fixed-dose-combination (FDC), this treatment will be considered as two types of drugs if the dose of each component of the FDC is equal to higher than the routine therapeutic dose.
- Blood homocysteine (Hcy)≥ 10μmol/L, or the patient is taking enalapril-folic acid;
- Subject has read and signed a written, informed consent form.
Exclusion Criteria- History of physician diagnosed stroke, myocardial infarction, heart failure, revascularization, or malignancy;
- Clearly diagnosed secondary hypertension;
- Undergoing regular renal dialysis or has been diagnosed with end-stage kidney disease;
- Congenital or acquired organic heart disease;
- Severe somatic disease preventing the participant from completing the trial, or based on the discretion of the investigators, the patient is incapable of participating;
- Contraindicated or intolerable to ACEIs (including enalapril-folic acid) or a history of severe adverse effects to ACEIs;
- Individuals with abnormal laboratory test results and/or clinical manifestations rendering them unsuitable to participate as judged by the investigators;
- Any factor likely to limit adherence to interventions or jeopardize data collection, for example: dementia, severe mental disorders impeding expression or communication abilities, an inability to adhere the follow-up plan, plans to move in the near future, or, a history of unreliability in following a medication regimen or in keeping appointments;
- Living with a family member (a spouse, for example) who has already participated in the study;
- Unwilling to participate, unwilling or unable to change current therapeutic regimen;
- Currently (or within one month) participating in another new drug trial.