Despite the large body of evidence available for the middle-aged population, it is still unclear what the predictive value of high blood pressure in the elderly population is, or whether it should be treated to reduce the risk of mortality. Since the current guideline proposing that 'lower is better' may not apply to the blood pressure levels of all elderly and the management thereof, specific guidelines that are dependent on the biological age of older persons are needed. Gait speed, as a proxy for frailty or biological age, could be utilised as a foundation for understanding the complex relationship between late-life blood pressure levels and mortality risk, and for categorising those older persons who are most likely to benefit from antihypertensive treatment. Increasing general awareness about the option of categorising individuals based on their biological age instead of chronological age will help to facilitate tailor-made blood pressure treatment for the aging hypertensive population.