In spite of the fact that plasma catecholamine levels, baroreflex activity, and hemodynamic pattern significantly change with age and drugs whose action is mediated via the sympathetic nervous system might be expected to cause different effects, the limited available data suggest that both alpha-methyldopa and clonidine lower blood pressure to a similar extent in young, middle-aged, and old patients. However, in the great majority of published works, only the mean or the range of the age are reported; therefore, it is difficult to compare the antihypertensive efficacy of the centrally acting drugs to the age of the individual patient. However, the blood pressure reduction with both drugs is significantly correlated to the pretreatment blood pressure values. Clearly, this area of risk versus benefit of centrally acting drugs has not been adequately investigated, and it is unlikely that this will happen in the future.