There is a linear change in blood pressure (BP) with the advancement of age from predominantly diastolic BP (DBP) in the young to predominantly systolic BP (SBP) in the old. This change is caused by the stiffening of the large arteries and the loss of elastic recoil as a result of replacement of the elastic fibers with collagen fibers. The result of this ageing process leads to an increase in pulse wave velocity and widening of pulse pressure. These hemodynamic changes are associated with an increased incidence in cardiovascular diseases (CVDs) and strokes. Recently, an inverse relationship with stroke risk was noted when the DBP was <71 mm Hg in persons older than 60 years. Accordingly, when treating SBP in the elderly, care should be taken not to lower the DBP below this level in order to minimize the risk for CVD and stoke.