Recently published clinical trials provide compelling evidence of the effec
tiveness of antihypertensive therapy to reduce cardiovascular mortality. Th
e Sixth Joint National Committee on Detection, Evaluation, and Treatment of
Hypertension emphasizes that hypertension is undertreated in this country:
only approximately one fourth of hypertensive persons have their blood pre
ssure controlled to the current recommended level of less than 140/90 mm Hg
. The point is especially pertinent to elderly patients, most of whom have
hypertension. Moreover, most elderly hypertensive persons have systolic hyp
ertension, which has an even stronger association with risk than does diast
olic pressure. Current recommendations are reviewed.