Hypertension guideline has been revised as JSH2014. Because the elderly show marked individual differences in the physiological function, the therapeutic strategies should be individually selected, considering their QOL. As to general guidelines, drug therapy should be indicated for patients with a blood pressure of ≤ 140/90mmHg on principle. However, treatment indication must be individually assessed in persons, aged over 75 years, with a systolic blood pressure of 140-149 mmHg or frail elderly. Target blood pressure in persons aged 65-74 years should be < 140/90mmHg and that in those aged over 75 years should be < 150/90 mmHg. If treatment is well tolerated, more aggressive blood pressure control < 140/90mmHg may further improve the outcome. In patients with coronary artery disease, the risk of cardiac events may increase if diastolic blood pressure is < 70mmHg. Therefore, blood pressure control should be performed while monitoring the ischemic findings.