Hypertension is an important risk factor for cardiovascular disease in women. Although younger, premenopausal women have lower blood pressures than age-matched men, population blood pressure rises with age, and the prevalence of hypertension is higher in older women. Oral contraceptive use increases the risk of hypertension in women, and women using this therapy should have blood pressure monitored twice yearly. The risk of hypertension is low in normotensive women receiving HRT. Few studies of HRT in hypertensive women have been performed, and more information is needed to assess the risk of worsening hypertension in hypertensive postmenopausal receiving this therapy. Investigations of gender differences in pathophysiology and response to treatment of essential hypertension have not been extensive, and current evidence does not support gender-specific treatment of hypertension at the present time.