Hypertension is an important risk factor for cognitive impairment. This study explored whether elderly patients with stage I hypertension (HPs) and normotensive patients (NPs) showed differences in the recovery of postoperative attention network function, according to attentional network test (ANT) performance.Of 110 patients screened, 25 HPs and 25 NPs completed this study. All participants completed the Mini-Mental State Examination 1 day preoperatively and the ANT on postoperative days (PODs) 2 and 7.Compared with NPs, HPs had significantly lower alerting network effect scores and more difficulty resolving conflict on POD 7. However, no significant difference was observed between groups on POD 2. Orienting network performance was similar between groups at all timepoints. Significant differences in alerting and executive control network performance were observed between PODs 2 and 7 within each group.HPs showed selective cognitive impairment at different timepoints following elective hip or knee arthroplasty. Compared with NPs, HPs were more likely to experience delayed recovery of alerting and executive control network function, but not orienting network function, during the first postoperative week.