Objective To explore the cardiovascular disease risk perception and its impact on self-management in rural elderly patients with hypertension, and to provide reference for further improving the self-management level of rural elderly patients with hypertension. Methods A total of 662 rural elderly patients with hypertension in Zhengzhou were selected by multi-stage stratified sampling method, and questionnaire survey was conducted by using the single-item cardiovascular disease risk perception assessment tool and the Hypertension Patients Self-Management Behavior Rating Scale (HPSMBRS). Results The total scores of cardiovascular di-sease risk perception and self-management were 2.00（1.00,4.00） and 113.42±23.24 respectively in the patients.The total scores of cardiovascular disease risk perception and self-management were significantly positively correlated （r=0.755,P＜0.001）.Hie-rarchical regression analysis showed that cardiovascular disease risk perception was an important predictor of self-management, independently explaining 27.1% of the variation in patient self-management. Conclusion Cardiovascular disease risk perception is an important factor affecting self-management of elderly patients with hypertension in rural areas.The higher the perceived risk of cardiovascular disease, the higher the level of self-management.