Objectives: to study subclinical target organ damage in elderly hypertensive patients in comparison with younger hypertensive ones, which were resistant to previous therapy Methods: The study included 137 patients with 2–3 stage of arterial hypertension, which were resistant to previous therapy in average age 55.84 ± 9.95 yrs. The patients divided into 2 groups: 1st group n = 25 (≥65 yrs.) patients in average age 69.2 ± 2.56 yrs., 2nd group n = 112 (<65 yrs.) patients in average age 52.9 ± 8.47 yrs. Office blood pressure (BP) was measured by Korotkov method. Echocardiography performed to all patients with evaluating of left ventricular mass index (LVMI) and left ventricular diastolic function (LVDF). Serum creatinine was measured with biochemical assay method. Glomerular filtration rate (GFR) was estimated using CKD-EPI. Results:.: Baseline blood pressure (BP) was 163.4 ± 15.4/97.4 ± 9.1 mmHg and 159.1 ± 15.1/99.1 ± 8.7 mmHg for 1st and 2nd groups respectively without statistically differs, but pulse BP was higher in 1st group: 65.6 ± 11.3 mmHg vs. 60.0 ± 10.7 mmHg, p = 0.021. 1st group patients had higher LVMI (151.7 ± 39.5 g/m2 vs. 139.3 ± 32.2 g/m2, p = 0.098), statistically worse of LVDF (E/A 0.69 ± 0.1 vs. 0.85 ± 0.3, p = 0.009) and significantly lower GFR (58.7 ± 13.5 ml/min/1.73m2 vs. 66.6 ± 13.6 ml/min/1.73m2, p = 0.01). Conclusion: Elderly patients with resistant hypertension had higher pulse pressure, significantly reduce of left ventricular diastolic function and renal function in comparison with younger untreated hypertensive patients.