Background In Canada, as elsewhere, control of hypertension in older persons who are using antihypertensive medication is more likely in men than in women. The reasons for the observed difference are not known. Data and methods Data are from cycle 1 of the 2007 to 2009 Canadian Health Measures Survey (CHMS). The CHMS includes a comprehensive questionnaire, automated blood pressure (BP) measures, and a variety of biological and anthropometric assessments. Frequencies, means, cross-tabulations and multivariate models were produced to study differences between the sexes in hypertension control in a weighted sample representative of the household population aged 60 to 79. Results The prevalence of hypertension was nearly equal among older men (60%) and women (59%), and the percentage of those with hypertension who were receiving pharmaceutical treatment was not statistically different (84% and 89%, respectively). However, despite current treatment, hypertension was uncontrolled in a substantially higher percentage of women (30%) than men (17%). The difference persisted when age, socio-economic status, co-morbidity, category of medication, anthropometry, and other correlates of hypertension were taken into account. Interpretation The factors considered in the analysis do not account for the advantage to older men in hypertension control. The findings underscore the importance of efforts to control blood pressure in older women.