Various clinical studies focusing on the treatment of hypertension in the very elderly (over 80 years old) have yielded inconclusive results of all-cause mortality. Results of the HYVET study prove that early and systematic therapy of hypertension with indapamide or indapamide and perindopril in this age group reduces the risk of all-cause mortality, stroke mortality, cardiovascular incidents and heart failure development. The treatment of hypertension demands a holistic approach to the patient regarding global cardiovascular risk and individualization of hypertensive therapy.