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Objective: To investigate the effects of long-term low-dose hormone replacement therapy (HRT) on blood pressure, the plasma renin activity (PRA), plasma angiotensin Ⅱ (Ang Ⅱ) level and serum nitric oxide (NO) concentration in postmenopausal women.Methods: A total of 140 postmenopausal women were selected from the medical staff of the Peking Union Medical College Hospital. Of these, 63 subjects who had been treated with low-dose sex hormone for over 5 (5-32) years were set up as HRT group, and 77 age-matched subjects who had never received HRT were designed as control group. The levels of serum estradiol (E2), follicle stimulating hormone (FSH) and nitric oxide (NO), the concentration of plasma angiotensin Ⅱ (Ang Ⅱ), plasma rennin activity (PRA) and the blood pressure were evaluated in these two groups.Results: The serum level of estradiol in HRT group was significantly higher than that in control group(median,interquartile range; 124.0 pmol/L,113.4 vs. 78.2 pmol/L,121.8)(P＜0.05)and systolic blood pressure in HRT groups was significantly lower than that in control group [(126.7±14.4) mmHg vs. (132.4±19.8) mmHg] (P＜0.05). Diastolic blood pressure [(79.7±7.9) mmHg vs. (79.6±10.4) mmHg], the serum level of FSH [(54.4±18.9) IU/L vs. (60.4±24.4) IU/L], the plasma level of PRA(median,interquartile range; 0.14 pg/L/hr,0.11 vs. 0.12 pg/L/hr,0.10), Ang Ⅱ(median,interquartile range; 46.0,31.1 pg/ml vs. 44.4,33.0 pg/ml)and serum level of NO(median,interquartile range;63.8 μmol/L,58.9 vs. 56.0 μmol/L,94.8)showed no significant difference between HRT and control groups (P＞0.05).Conclusions: Long-term low-dose HRT decreased the systolic blood pressure, but showed no effects on the diastolic blood pressure, plasma level of Ang Ⅱ, PRA, and serum level of NO in postmenopausal women.