Objective: To evaluate the effects of atorvastatin calcium on clinical manifestations and serum inflammatory markers in elderly patients with hypertension. Methods: This retrospective cohort study included 68 elderly patients with hypertension admitted to the Chongming Branch of Shanghai Tenth People's Hospital between March 2022 and June 2023. Patients were matched into two groups, each comprising 34 participants: a control group receiving amlodipine besylate and an experimental group receiving additional atorvastatin calcium. The study compared blood pressure, lipid profiles, and serum inflammatory markers before and after treatment between the CRP), and interleukin-6 (IL-6). Indices of target organ function measured were urinary microalbumin (mAlb), endogenous creatinine clearance (Ccr), and various cardiac structural indices, including left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and left ventricular posterior wall thickness (LVPW). Adverse reactions post-treatment were also recorded. Results: Post-treatment assessments indicated significant reductions in both diastolic and systolic blood pressure (DBP and SBP), as well as improvements in lipid profiles (total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) in both groups. The experimental group exhibited greater improvements in 24-hour mean diastolic and systolic blood pressures after 4, 8, and 12 weeks of treatment compared to the control group (all P < 0.05). Additionally, serum inflammatory markers, including TNF-alpha, hs-CRP, and IL-6, were significantly lower in the experimental group than in the control group (all P < 0.05). The experimental group also showed superior improvements in mAlb and Ccr levels (both P < 0.05). Cardiac function indicators improved, with the experimental group showing greater increases in LVEF and more pronounced reductions in LVEDD and LVPW (both P < 0.05) compared to the control group. The incidence of adverse reactions was slightly lower in the experimental group (11.76%) than that in the control group (14.71%), although this difference was not statistically significant (P > 0.05). Conclusion: Adding atorvastatin calcium to amlodipine therapy significantly improves clinical outcomes and reduces serum inflammatory marker levels in elderly patients with hypertension. This combination therapy is considered safe and may be recommended for broader clinical application.