Hypertension is a highly prevalent disorder and a potent factor in promoting atherosclerosis. Identifying and controlling high blood pressure are major goals in caring for the vascular patient. A focused history and physical examination and selected laboratory studies will identify potential underlying (and remediable) causes of hypertension, target organ effects, and other risk factors for vascular disorders. Lifestyle changes and pharmacologic therapy tailored for this patient population are discussed, along with the importance of considering whether renovascular hypertension is present.