Hypertension is one of the most common cardiovascular diseases, with nearly 300 million people suffering from hypertension in China, and the incidence of hypertension is even higher in the elderly population. More than half of those older than 65 years old suffer from hypertension, and among those over 80 years old, the prevalence of hypertension even reaches about 90%. The physical functions and co-morbidities of the elderly are different from those of young and middle-aged people, so there should be individualized antihypertensive treatment plans for the elderly. In 2019, the Hypertension Branch of the Chinese Society of Geriatrics and the National Center for Clinical Medical Research on Geriatric Diseases China Alliance for the Prevention and Treatment of Cardiovascular Diseases in the Elderly jointly released the Guidelines for the Management of Hypertension in the Elderly in China 2019. This guideline elaborates on issues such as blood pressure measurement in the elderly, antihypertensive goals, treatment for specific populations, blood pressure fluctuations, multiple drug use, and blood pressure management. Here we will introduce some of the key points of the guideline with you. 1. Definition of geriatric hypertension: We define age ≥ 65 years as elderly, and this population is diagnosed with geriatric hypertension if systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg when blood pressure is measured three times on non-same day without the use of antihypertensive drugs. Geriatric hypertension is graded in the same way as general adult hypertension. 2. Evaluation of geriatric hypertension: For elderly patients with hypertension, in addition to determining their blood pressure levels, it is necessary to understand their cardiovascular risk factors, the presence of secondary hypertension and to assess the degree of target organ damage. It is also important to assess the cognitive function and the degree of physical frailty of the elderly, which is important for drug use and blood pressure monitoring. 3. Treatment of elderly hypertension: In the treatment of elderly hypertension, “gentle hypotension” is emphasized. The first priority should be to achieve the systolic blood pressure first, and under the premise of tolerated, gradually make the blood pressure to achieve the standard. The process of pressurization should be gentle to avoid various adverse reactions brought about by too rapid lowering of blood pressure, such as postural hypotension and aggravation of cerebral ischemia. For elderly patients aged ≥65 years with blood pressure ≥140/90 mmHg, initiate antihypertensive drug therapy along with lifestyle intervention to lower blood pressure to <140/90 mmHg. For patients aged ≥80 years with blood pressure ≥150/90 mmHg, blood pressure should first be lowered to <150/90 mmHg, and if well tolerated, further lowered to < 140/90 mmHg (still with emphasis on palliation). For debilitated elderly patients, if blood pressure is ≥ 160/90 mmHg, initiate antihypertensive drug therapy with similar control goals as before, but try not to go below 130 mmHg. 4. Principles of antihypertensive drug application in the elderly: gentle antihypertensive, starting with small doses of antihypertensive drugs, thiazide/like diuretics, CCB, ACEI and ARB can be recommended for the initiation and maintenance of antihypertensive therapy. Try to use long-acting antihypertensive drugs to control intra-night and morning peak blood pressure. If single-agent antihypertensive effect is poor, apply a combination drug to lower blood pressure as early as possible. Combination therapy with three drugs, namely thiazide/like diuretics, CCB, ACEI or ARB, is recommended. However, on the debilitated elderly, the combination of drugs at the beginning is generally not recommended because of the risk of causing a rapid drop in blood pressure. During the treatment process, it is necessary to closely monitor blood pressure and assess the patient's tolerance to blood pressure, responsiveness to drugs, etc., and adjust the treatment plan at any time. China has gradually entered an aging society, and the proportion of people older than 65 years of age in the population will gradually increase in the future. The introduction of individualized antihypertensive guidelines for the elderly is of great significance. Because of the degradation of organ function and metabolic capacity of the elderly, as well as the frailty and low body weight of many elderly people, this requires that we should be more "patient" and "individualized" in the antihypertensive treatment of the elderly. Standardized, reasonable and effective blood pressure lowering will greatly reduce the occurrence of cardiovascular and cerebrovascular diseases in elderly patients.