The behaviour of blood pressure after pacemaker implantation was investigated in 278 patients in a long-term follow-up. Prospective analysis was done in 151 patients and 127 patients were assessed retrospectively. Pacemaker implants were ventricle triggered demand systems. The observation period was between 18 and 80 months. After implantation lowering of systolic pressures can be expected. Provisional care for overcoming this stage is indicated., In the majority of patients blood pressure rises after 3 to 5 months to pre-implantation values. Drug treatment must consider these changes of blood pressure behaviour. Permanent decrease of systolic blood pressure was observed only in small number (5.8%) of pacemaker patients.