According to the mata-analysis on the management of hypertension and guidelines published in recent years concluded that the amount of blood pressure reduction, not the choice of antihypertensive drug is the major determinant of reduction in cardiovascular morbidity and mortality in the both younger and older partients with hypertension. However still remained the some patients having an indication for a specific drug or drugs that is helpful to those of the patients with diabetes, chronic kidney disease, ischemic heart disease, heart failure or atrial fibrillation. Thus, individualized, tailored drug therapy would be preferred to stepped care approach in the management of essential hypertension. (Korean J Med 2011;80:280-285)