Objective: To evaluate the recent curative efficacy and security of angiotensin-converting-enzyme inhibitor (ACEI) in combination with chemotherapy treated patients with advanced pancreatic carcinoma and hypertension. Methods: Sixty-eight cases of advanced pancreatic cancer treated in Beijing Friendship Hospital were retrospectively collected; according to the types of antihypertensive drugs, the patients were divided into an ACEI + gemcitabine chemotherapy group and a calcium channel blocker (CCB) + gemcitabine chemotherapy group, and the difference in overall survival (OS) and progression-free survival (PFS) between two groups of patients were observed. Results: The OS of the ACEI + gemcitabine chemotherapy group was (12.26±2.81) months, while (9.68±1.65) months in the CCB + gemcitabine chemotherapy group. The PFS of ACEI + gemcitabine chemotherapy group was (7.17±1.54) months, and (5.35±1.12) months in the CCB + gemcitabine chemotherapy group. The difference in OS and FPS between the two groups was all statistically significant (P<0.005). Cox regression analysis showed that the use of CCB and ACEI and ECOG score are independent risk factors of the OS and PFS, HR of OS in the two groups were 3.000 (95% CI 1.70–5.29, P<0.05). The independent risk factors of PFS were the same as OS. The age, sex, tumor site, and the severity of hypertension are not of significant value (P>0.05) to the OS and PFS. Conclusion: ACEI combination gemcitabine chemotherapy may improve the prognosis of advanced pancreatic cancer, and can be applied in patients with pancreatic cancer and hypertension.