The different intervention trials in elderly hypertensive subjects are compatible with the hypothesis that antihypertensive drug treatment decreases cardiovascular mortality, mainly by a reduction of cerebrovascular mortality. Antihypertensive drug treatment in elderly hypertensive subjects also leads to a decrease in fatal and nonfatal cardiovascular and cerebrovascular events. It has not yet been proven whether antihypertensive drug treatment should be recommended for symptomless patients with isolated systolic hypertension and for patients with uncomplicated hypertension above the age of 80 years.