To determine the benefits of the long-term monotherapy with nifedipine in the elderly hypertensive patients, 100 subjects > 60 years old were included to the trial. Therapeutic efficacy of nifedipine was confirmed in 69% of the patients and resulted in reduction of SBP by 20.9% and DBP by 19.0% of their initial values, from 179.7/101.3 to 142.1/82.9 mmHg (p < 0.001). On the other hand, the range of circadian changes in systolic and diastolic BM did not decrease (67.1 and 37.0 mmHg before treatment and 65.0 and 36.2 mmHg at the end of the trial). Although cardiac output and ejection fraction significantly improved, the patients showed neither a significant reduction of left ventricular mass (313.6 g before and 282.4 g after therapy) nor a decrease in cardiac arrhythmias. Usefulness of long-term monotherapy with nifedipine in elderly patients is diminished by side-effects (11%), as well as a preserved high circadian BP variability and the unchanged left ventricular morphology that may result in persistent cardiac arrhythmias despite of the significant fall in BP.