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Background: In view of the aging population, the target value for treatment in elderly hypertensive patients is today a clinically relevant problem. Methods: STEP and SPRINT studies enrolled elderly subjects with exclusion of previous stroke patients. However, STEP enrolled subjects at lower cardiovascular risk than SPRINT. Results: In Chinese hypertensive patients aged 60–80 years enrolled in the STEP study, intensive blood pressure treatment (systolic blood pressure target of 110–130 mmHg) reduced the primary composite cardiovascular endpoint and stroke with no effect on cardiovascular death and renal harm, two endpoints significantly affected in SPRINT. Conclusion: Differences with SPRINT are the lower cardiovascular risk and CKD prevalence of STEP population.