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Hypertension is highly prevalent in elderly individuals, the most rapidly growing segment of the US population. Epidemiologic studies have established that increased risk of cardiovascular disease is associated with elevated blood pressure. Treatment of hypertension in elderly patients significantly reduces their cardiovascular morbidity and mortality. However, antihypertensive therapy is often challenging in this patient population because of potential metabolic and physiologic alterations, multiple comorbidities, polypharmacy, and biologic variability. Drugs with a convenient dosing schedule, minimal side effects, and the ability to impact comorbid conditions are important considerations in the treatment of hypertension in the elderly.