A related editorial discusses the study and comments that an increasing body of evidence implies that a “one size fits all” approach in antihypertensive therapy needs to be replaced with an individualised approach based on chronological age, biological age or the degree of systemic and cerebrovascular damage, and haemodynamic status. Furthermore, there is an urgent need for interventional studies among high-risk groups, applying various classes of antihypertensive medications, to shed further light on the optimal control of blood pressure in older persons with and at risk of cognitive impairment.