HYPERTENSION: Edited by Hector O. Ventura and Carl J. LavieHypertension in the elderly: recent developments and insightsSternlicht, Hillela; Basile, JanbAuthor Information aDivision of Nephrology and Hypertension, Department of Medicine, Wayne State University School of Medicine-Detroit Medical Center, Detroit, Michigan bSeinsheimer Cardiovascular Health Program, Division of Cardiology, Ralph H Johnson VA Medical Center, Medical University of South Carolina, Charleston, South Carolina, USA Correspondence to Hillel Sternlicht, MD, Harper Professional Building, Division of Nephrology and Hypertension, 4160 John R Street, Suite 917, Detroit, MI 48201, USA. Tel: +1 313 312 5525; fax: +1 844 391 7655; e-mail: email@example.com Current Opinion in Cardiology: July 2020 - Volume 35 - Issue 4 - p 351-356 doi: 10.1097/HCO.0000000000000755 Buy Metrics Abstract Purpose of review This article will summarize the effects of more intensive blood pressure (BP) control on cardiovascular, cognitive, and renal outcomes among elderly (age ≥75 years) individuals at high risk for cardiovascular events. Subsets of patients who may not benefit and obstacles to implementation will be addressed. The authors’ insights will conclude the review. Recent findings A burst of new research regarding the effects of lower BP targets on cardiovascular, cognitive, and renal endpoints among the elderly has been published. Achieved values of 123 mmHg systolic in those without diabetes or prior stroke revealed striking declines in all-cause mortality, heart failure, and stroke. Although there was no benefit on the incidence of dementia, mild cognitive impairment was reduced. A trend towards modest declines in renal function and higher adverse event rates with normalization of BP were noted. Whether those with poor functional status or diastolic hypotension realize comparable gains remains unknown. Summary Intensive BP control (systolic goal 120–130 mmHg systolic) results in lower rates of all-cause mortality and major adverse cardiac events. Elderly individuals with a good functional status and no history of diabetes or stroke are suitable candidates. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.