Summary: The incidence of hypertension increases with age. In people older than 65 years, hypertension is diagnosed in more than 60% of patients. The most common form of hypertension in the elderly is isolated systolic hypertension, which is the result of the aging process and an increase in arterial stiffness, and consequently a loss of their compliance and flexibility. Different pathophysiology of hypertension in the elderly means that the management of hypertension in this group of patients may differ as compared to younger age groups. It is emphasized that with age and the aging-related increase in the stiffness of vessels, and as a consequence the development of isolated systolic hypertension, the risk of stroke and its complications increases particularly in patients > 65 y.o. The current guidelines of the Polish Society of Hypertension pay special attention to the differences in the management of hypertension in the elderly. Due to the high effectiveness of diuretics and calcium antagonists in the treatment of elderly patients, especially those with isolated systolic hypertension, and the documented effect of these drugs on reducing the risk of myocardial infarction and stroke, current guidelines recommend the use of calcium antagonists or thiazide-like diuretics in the therapy of the elderly (in monotherapy and optimally as a single pill combination).