Summary: Polish society is aging. With advancing age, the prevalence of hypertension increases. Ninety percent of persons who live past 50 years of age will develop hypertension sometime during their remaining lifetimes. The approach to hypertension in the older patient should take into account such elements as multimorbidity, increased risk of drug interactions, dysfunction of the autonomic system, physiological changes with age, and different pathogenesis and types of hypertension (most often: isolated systolic hypertension, ISH). Antihypertensive treatment of a geriatric patient in daily practice requires caution, and taking into account factors that can potentially change the course of the disease and treatment. We propose five principles as pillars of hypertension management in the elderly patient. Following the proposed principles would make it easier to understand the disease in a given patient and would lead to a holistic approach to the treatment process and proper follow-up.