Discusses the case of Mr. J, a 42-year-old African-American first diagnosed with hypertension when he was 28. Medical background; Comments from Mr. J; Prevalence and epidemiology of hypertension; Etiology and pathogenesis of essential hypertension, especially in blacks; Management of hypertension; Pharmacological treatment; Cardiovascular outcomes of antihypertensive treatment; Management of resistant hypertension; Questions and discussion.