Hypertension is an important risk factor for cardiovascular disease in the Caribbean and globally. It is responsible for 51% of deaths due to cerebrovascular disease (stroke) and 45% of deaths due to ischaemic heart disease, which are the leading causes of death in the Caribbean. The prevalence of hypertension in the Caribbean is high, affecting 21% of adults in Barbados and Trinidad and Tobago, 25% in Jamaica, and 35–38% in St Kitts, British Virgin Islands and Grenada, contributing to the large economic burden from this condition and its complications. The benefits from adequate treatment and control of hypertension are considerable. There is strong high-quality evidence from clinical trials and meta-analysis that lowering blood pressure reduces the risk of cardiovascular disease (stroke, coronary heart disease and heart failure), diabetes complications, chronic kidney disease and premature death.