Approximately one in four adults has hypertension, a prevalence that increases with age and may reach to two out of three adults older than 70 years of age. In the Framingham Heart Study 65-75% of hypertension in the elderly is of the isolated systolic hypertension variety. Hypertension causes a two- to threefold increased risk of atherosclerotic cardiovascular events. Hypertension clusters with dyslipidaemia, insulin resistance, glucose intolerance and obesity in more than 80% of cases. The great majority of hypertensives thus have additional cardiovascular risk factors. The global cardiovascular risk, of which hypertension is but one component, is best appreciated by the use of risk charts such as the Framingham Risk Score.