Adequate treatment of high blood pressure reduces the risk of strokes and other cardiovascular events, but current treatment in UK general practice is often inadequate. Nurse-led management of people with high blood pressure could lead to improvements due to strict adherence to protocols, agreed target blood pressure, better prescribing and compliance, and regular follow-up. However, a review of the literature shows a lack of robust evidence of the effectiveness of nurse-led hypertension management in primary care. There is a clear need for randomized controlled trials to see if nurse-led management is associated with better blood pressure control than routine care.