Hypertension is the most common cause of excessive mortality in global population. The incidence of hypertension is increasing with age among others as a consequence of processes taking place in the arteries, mainly their stiffness. A special form of hypertension, found particularly in the elderly, is isolated systolic hypertension. It increases a risk of death caused by cardiovascular diseases. Hypotensive therapy in the elderly gives them benefits, but it has to be conducted following particular principles, like individualization of the therapy and careful reducing of blood pressure.