Experience over two years with 376 hypertensive patients managed at a clinic where the primary observations are made by a trained nurse, clinical information is held on a microprocessor, and treatment follows a standard stepped care approach has been assessed. Blood pressure control after both one and two years was appreciably improved, with over 70% of patients having diastolic pressure below 90 mm Hg compared with 22% of patients when they first attended the new clinic. The non-attendance rate was half that of the conventional hospital outpatient clinic. A computer based record system with a nurse run hypertension clinic is acceptable to patients and offers the possibility of more effective long term control of blood pressure in large numbers of patients.