Abstract: Objective To evaluate the effectiveness of health education among middle and old aged hypertension patients in rural areas of Shandong province and to provide evidences for making hypertension prevention strategies.Methods Hypertension patients identified among rural physical examinees aged 55-75 years from 3 counties (Pingyin,Liangshan,and Lünan county)in Shandong province were randomly assigned into an intervention group (548 from 8 villages)and a control group (285 from 4 villages)in October 2009.Five episodes of trainings on hypertension medication and health education skills were performed among village doctors responsible for the management of the hypertension patients of the intervention group between July 2013 and July 2014.Four waves of follow-up were conducted among all the hypertension patients by village doctors according to the requirement of national basic public health service.The changes and difference in blood pressure measured at the physical examination and the follow-up at the end of the study were compared between the patients of intervention and control groups.Results Compared with those before the intervention,the average systolic blood pressure (SBP,mm Hg)and diastolic blood pressure(DBP,mm Hg)significantly decreased at the end of intervention among the patients of the intervention group (P < 0.05)and compared to those of the control patients,the intervened patients had significantly larger decreases in SBP (11.79 ± 2.19 vs.10.72 ± 25.39)and DBP (7.24 ± 1.14 vs.6.44 ± 12.36)(both P < 0.05).Compared to the female intervened patients,the male intervened patients showed significantly larger decreases in SBP (13.06 ± 22.88 vs.10.66 ± 20.85)and DBP (8.64 ± 11.70 vs.5.99 ± 10.99)(both P < 0.05);whereas,compared to the female control patients,the male control patients showed significantly smaller decreases in in SBP(9.61 ± 24.78 vs.11.81 ± 26)and DBP(6.16 ± 13.32 vs.6.71 ± 11.37)(both P < 0.05).At the end of the study,significantly smaller decreases were observed among both the intervened and control patients aged ≤65 years in SBP(10.84 ± 19.58 vs.12.49 ± 23.78 and 8.70 ± 23.39 vs.12.03 ± 26.92)and in DBP(7.10 ± 11.11 vs.7.41 ± 11.56 and 5.84 ± 12.85 vs.6.88±12.13)compared to among those aged >65 years(all P < 0.05).Conclusion The intervention aimed to promote hypertension medication and health education skills among village doctors could effectively decrease systolic and diastolic blood pressure among middle and old aged hypertension patients under the management of the doctors trained in rural areas of Shandong province.