Isolated systolic hypertension affects 8% to 15% of all people older than 60 years of age. In the elderly, systolic hypertension is the major modifiable cardiovascular risk factor. Three placebo-controlled outcome trials on antihypertensive drug treatment of this disorder have been published. This article briefly reviews the main findings of each of these three trials and presents pooled estimates of the benefit of antihypertensive drug treatment for elderly patients with isolated systolic hypertension. A total of 11, 825 patients were enrolled in the Systolic Hypertension in the Elderly Program (SHEP, n = 4736), the Systolic Hypertension in Europe (Syst-Eur, n = 4695), and the Systolic Hypertension in China (Syst-China, n = 2394) trials. The outcome results of these trials were pooled by calculating the common odds ratio for active versus placebo treatment. The pooled results of the outcome trials in older patients with isolated systolic hypertension prove that antihypertensive drug treatment must be prescribed if, on repeated measurement, systolic blood pressure is 160 mm Hg or higher.