New evidence suggests that there is an interaction between age and DBP regarding CA for patients older than 60 years. Similar findings in the shift of BP with age have been reported by other investigators with respect to CVD and stroke risk.[23, 24] In the study by Vishram and colleagues, as well as Safar and associates, DBP was the strongest predictor of CVD risk in persons younger than 50 years, whereas in persons 60 years and older, SBP was the strongest predictor. In persons aged 50 to 59 years, both pressures were equally important. Another significant finding from the study by Vishram and colleagues is the J-curve effect of DBP with stroke risk in participants older than 60 years, when their DBP dropped to <71 mm Hg. Such an association is not commonly seen with strokes, in contrast to CVD,[22, 25-27] although it has been reported by some investigators. This is important when treating elevated SBP in the elderly. Kannel and coworkers showed that the incidence of cardiovascular events increased with a decrease in DBP <80 mm Hg when the SBP remained ≥140 mm Hg. Similar increases in CVD and stroke were reported by Fagard and colleagues, when the DBP level dropped to ≤55 mm Hg due mostly to the widening of PP. In the study by Kannel and associates, the 10-year risk ratio (RR) of cardiovascular events for men and women was 1.22 (95% confidence interval [CI], 0.97–1.50) with PP 46 to 55 mm Hg. The RR increased to 1.66 (95% CI, 1.32–2.07) with a PP 55.5 to 136 mm Hg. The significance of PP as a stroke[6, 24, 31, 32] and cardiovascular risk has also been demonstrated by other investigators.[13-16] This higher cardiovascular risk has been attributed to the increased pulsatile burden on the heart and blood vessels caused by the wide PP. In this regard, the Framingham study tracked the age and sex of 4993 participants for 28 years and demonstrated that the SBP and PP became higher with older age, they were higher in older women than men of similar age, and were associated with an increase in cardiovascular risk. Given that both PP and chronological age are positively associated with high risk for CVD and strokes, PP may be regarded as an index of arterial ageing. This could suggest that the chronological age as determined by calendar time is distinct from biologic age, which is a progressive and irreversible process of deterioration of the vitality of organ systems. In addition, an inverse association has been found between PP and telomere length, suggesting that the biologic age of persons with wide PP is more advanced than their chronological age would indicate. With respect to the interrelationship of BP with age regarding the treatment of hypertension, it appears that both SBP and DBP are important up to the age of 50 years, after which the value of the SBP supersedes the value of DBP. Therefore, when treating BP in older persons, attention should be paid to not lower the DBP below 71 mm Hg to avoid the risk of CVD and stroke, which increase significantly below this DBP level. Several studies have shown that the aggressive lowering of BP did not produce the expected results and that milder lowering of BP in older people to 150/90 mm Hg has been shown to reduce the risk of stroke and myocardial infarction. The new European guidelines now recommend that the BP of older persons be reduced to ≤150 to 140/90 mm Hg, in contrast to previous stricter guidelines recommending BP reduction to <140/90 mm Hg and for persons with high cardiovascular risk to <130/80 mm Hg.