At present there are 1.93 million people aged over 65 years and 420,000 people aged over 80 years in the Czech Republic. Hypertension is one of the major risk factors of cardiovascular disease. Its prevalence increases with age and so does the number of other risk factors and comorbidities. Hypertension is characterised by reduced elasticity of large arteries and increased systolic and pulse pressure. The target levels of blood pressure are below 140/90 mmHg for persons aged 65-80, and below 150/90 mmHg in persons over 80 years. All five recommended groups of drugs are used in the treatment, preferably at lower doses and in fixed combinations. Diuretics and long-acting calcium channel blockers are most effective in reducing systolic and pulse pressure. An appropriate treatment of hypertension reduces the incidence of cardiovascular events and prolongs active life in the elderly.