Background: The prevalence of chronic coronary heart diseases (CHDs) increases with age in the elderly, which represents one of the top-ranked causes of death and disease burden. Methods: This study aimed to investigate the management efficiency of telemedicine based on the remote multiparameter monitoring in elderly patients with CHD. A total of 1248 elderly patients diagnosed with CHD were enrolled. The subjects were randomly divided into two groups, wearable equipment-based telemedical management (WTM) group and traditional follow-up management (TFM) group. Face-to-face clinical interview at least once every 2 months was required in TFM group to collect the medical records. Patients in WTM group were provided with wearable equipment to complete remote monitoring, real-time alerts and health intervention via virtual consultations and remote medication recommendations. Results: The mean age of patients in WTM group and TFM group was 71.1 (68.0–82.0) years and 71.0 (68.0–81.0) years, respectively‏. After a 12-month management, patients in WTM group presented a lower occurrence of hospitalisation (HR 0.59, 95% CI=0.47 to 0.73, p<0.0001) and major adverse cardiac events (HR 0.60, 95% CI=0.44 to 0.82, p=0.0012) compared with patients in TFM group. Conclusion: The multiparameter telemedical management could help with the out-of-hospital management and reduce the incidence of rehospitalisation in elderly patients with CHD.