There will be twice as many individuals over the age of sixty worldwide, including in the Asia-Pacific region by the year 2050, according to a report by WHO. The rise in hypertension prevalence, therefore, will be fueled by the anticipated rise in the elderly population. Even though cardiovascular (CV) risk factors continue throughout a lifespan, older people are more likely to develop cardiovascular diseases (CVDs). Hypertension accounts for a significant share of major morbidities and mortalities in the Asia-Pacific area. Therefore, the main objectives of integrated healthcare for older populations are to minimize CV risks as well as to provide optimal treatment of CVDs and life-threatening conditions. Another critical factor is the continuity of healthy metabolic profiles including blood pressure from childhood to old age. There are many challenges in hypertension management with social aging in the Asia-Pacific region. First, the common type of hypertension in the elderly is isolated systolic hypertension. Its prevalence is expected to rise in many parts of Asia, however, clear guidance for the management is not yet provided. Second, a relatively high salt intake which is known as one of the most important risk factors for hypertension has been reported in the Asia-Pacific region. The genetic epidemiology network of salt sensitivity dietary feeding study reported that nearly 40 percent of Chinese adults were salt-sensitive. Moreover, salt sensitivity is more common in older individuals who are more susceptible to CVDs. Therefore, the action to lower salt intake is an immediate requirement. Finally, relatively poor compliance is more common in older individuals, whether it is because of their impaired functions or because of possible intolerance of medications, and drug-drug interactions. The recent trials of fixed-dose combinations and polypills showed that they may help improve compliance. However, reimbursement is still a problem in some areas. The Asia-Pacific regional strategy including adapting the healthcare systems to solve these challenges is needed to reduce CVD-associated morbidity and mortality in our older populations.