Isolated systolic hypertension and combined systolic and diastolic hypertension are clinical problems affecting significant numbers of older adults (>65 years). Preventing the complications of hypertension, including stroke and coronary artery disease, may potentially impact not only an individual's sense of well-being, but also their functional status and ability to live independently in the community. Despite the increased absolute risk for cardiovascular events associated with hypertension in older adults compared with younger adults, significant numbers of individuals remain untreated or inadequately treated. There is clinical data to show that treating both isolated systolic hypertension and combined systolic and diastolic hypertension results in a significant reduction in cardiovascular events in older adults. Although there is a growing body of literature on treatment of hypertension in the 60- to 80-year-old, the data on individuals greater than 80 years old is lacking. The challenge becomes to treat hypertension safely in the presence of multiple medications and other diseases.