In 1988, Matilla et al1 reported that, among the very old, elevated systolic and diastolic blood pressure (BP) were associated with longer survival. The differences were not subtle. The 5-year survival of those with systolic BPs greater than 200 mm Hg were almost twice as high as those with levels of 120 to 140 mm Hg. Over the ensuing 25 years, a substantial number of population-based studies have reported the same findings: in those older than 85 years (or older than 80 years in some studies), high BP is an excellent prognostic sign.2,3