Preliminary observations were made to assess the antihypertensive efficacy and safety of treatment with valsartan plus spironolactone. Thirteen hypertensive patients were studied, 7 were males (54%), and 6 females (46%) with an age range from 61 years to 83 years (mean: 74+/-7.1 years). Patients had a mean daytime SBP/DBP of 164+/-9.2/99+/-9.5 mmHg. Echocardiography showed cardiac hypertrophy and mild cavity enlargement in all patients. After baseline measurements of HR, serum creatinine and electrolytes (potassium and sodium), patients received valsartan 80 mg/day plus spironolactone 100 mg/day for concomitant chronic heart failure due to hypertension. Study parameters were measured at the 30, 60, and 90 day of therapy. Mean ambulatory SBP/DBP monitoring, mean Holter heart rate, mean serum creatinine, and mean serum electrolytes (sodium and potassium) were recorded. These parameters did not show statistically significant changes after 90 days of follow up, except in one patient who had an increase in serum potassium concentration from 4.3 mmol/l to 5.8 mmol/l after 30 days of therapy. Mean BP was reduced up a maximum of 7%. No side effect was seen in the study patients. Combination therapy valsartan and spironolactone seemed to be an effective and safe approach for older hypertensive patients with mild concomitant chronic heart failure.