Hypertension in the elderly is a frequent occurrence and is associated with an increase in cardiovascular complications. Therapeutic drug intervention in diastolic-systolic hypertension is both safe and effective in decreasing cardiovascular morbidity and mortality. Convincing evidence supporting the value of therapeutic intervention in isolated systolic hypertension is not yet available. At present, selection of specific antihypertensive drugs remains empirical because of insufficient controlled trials in elderly hypertensives. Antihypertensive agents should be initiated in smaller dosages and titrated upward slowly with particular care in avoiding orthostatic hypotension. Above all, lifestyle modification should be kept to a minimum and special attention should be given to the patient's quality of life while on drug treatment.