Hypertension is one of the most important risk factors for cardiovascular disease. Its prevalence and incidence increase progressively with age. A survey of hypertension in community-dwelling older adults in Tuscany disclosed a prevalence of 72.3% (1), in agreement with other studies conducted in Europe and the United States. The high prevalence of hypertension in the elderly population is due to the progressive increase in systolic blood pressure (SBP) with age, a phenomenon that only a few years ago was considered physiological and free of ominous consequences. Both systo-diastolic and isolated systolic hypertension (ISH) are important cardiovascular risk factors in older patients, as demonstrated by several epidemiologic studies and outcome trials (2-4). In the last years, epidemiological studies showed that systolic, not diastolic, blood pressure (BP) is the best predictor of coronary artery disease, stroke and end-stage renal disease (5). Somewhat unexpectedly, in patients with ISH participating in both observational studies and clinical trials, diastolic BP seemed to be inversely related to the incidence of cardiovascular events and stroke (6, 7). Moreover, pulse pressure, a marker of arterial stiffness, is strongly associated with age and cardiovascular risk (6, 7).