BACKGROUND Hypertension is a growing global health concern, particularly among the elderly, and is a significant contributor to cardiovascular and cerebrovascular diseases. Managing hypertension in elderly patients is particularly challenging, requiring continuous monitoring and strict adherence to treatment protocols. This study aimed to evaluate the effectiveness of integrated management strategies that utilize wearable devices in enhancing hypertension management for elderly patients. MATERIAL AND METHODS A total of 400 elderly patients with primary hypertension from the People's Hospital of Pudong New Area, Shanghai, and the Heqing Community Health Service Center were selected from September 2022 to November 2023. These patients were randomly assigned to either an experimental group or a control group. The experimental group used a chronic disease management platform based on wearable devices, which enabled real-time monitoring and personalized interventions. The control group received traditional hypertension management. RESULTS The experimental group achieved significantly better outcomes across multiple areas compared to the control group, including improved medication adherence, enhanced blood pressure control, and better quality of life encompassing overall health, physical, social, and emotional functions. Additionally, the experimental group showed enhanced knowledge of hypertension and superior self-management abilities, covering aspects such as diet, medication, and emotional management. CONCLUSIONS This study highlights the potential of wearable device-based chronic disease management platforms in significantly improving hypertension control, treatment adherence, quality of life, and self-management capabilities among elderly patients. The findings suggest that such technology-driven solutions can address the challenges of hypertension management in elderly populations, providing a critical tool for long-term disease management.