Systolic blood pressure rises with age, and the prevalence of hypertension (systolic pressure of 140 mmHg or more and diastolic pressure below 90 mmHg) exceeds 70% after the age of 70. At any age, high systolic pressure is associated with an increased risk of cardiovascular death, stroke and myocardial infarction. Antihypertensive drugs reduce cardiovascular mortality and morbidity in patients with systolic pressure exceeding 160 mmHg. The ability of blood pressure reduction to prevent cardiovascular events in elderly hypertensive patients is often compromised by poor systolic pressure control. This is due to the relatively limited efficacy of antihypertensive medications to normalize systolic blood pressure, but also to the fact that many physicians fail to follow systolic hypertension treatment guidelines.