According to published studies, much of the cost of hypertension is due to antihypertensive drug treatment. However, the cost of hypertension also includes the cost of an increased frequency of cardiovascular events when hypertension is not controlled. Although conceptually accepted by the scientific community, the achievement of appropriate blood pressure levels is less feasible than expected and studies demonstrate that only 13-27% of hypertensive patients are adequately informed, treated and controlled for their hypertension. This puts a tremendous burden on the healthcare system and society, since uncontrolled hypertension leads to higher rates of cardiovascular events and ultimately death. This paper demonstrates the paucity of reliable cost-of-illness estimates for the long-term consequences of uncontrolled hypertension and suggests that it is understandable that public and private payers focus on the immediate short-term costs of treating hypertension, paying less attention to potential cost savings of fewer cardiovascular events, as these costs are far less well defined. This paper also suggests that hypertension as a disease is an ideal candidate for disease management strategies and programs, as prevention of its long-term consequences should be the focus of medical treatment and could be better achieved through an integrated multispecialist and multisetting approach.