In the last half century we have seen huge strides in our understanding and management of hypertension, which has contributed to the significant reduction in cardiovascular morbidity and mortality. These advances have also given rise to many everyday questions in General Practice which remain less understood and researched. This talk will address a few of those uncertainties. One simple uncertainty is the practical question of how and when to monitor blood pressure, in both non-hypertensive and hypertensive patients. Common sense and new statistical methods give somewhat different answers. While drug therapies have made great advances, but non drug therapies have seen far less uptake for both practical and marketing reasons. We know that salt reduction reduces blood pressure, but a practical barriers is how to achieve that in community practice: of the methods in trials, what works is not practical, and what is practical doesn't work. Recent trials of salt substitution offer one solution, but practical challenges remain. Finally, hypertension is not an isolated cardiovascular risk factor. Individual patients management requires the context of other risk factors, such as lipids, glucose, smoking status, etc. Hence the recent National Heart Foundation guidelines recommend a holistic cardiovascular risk assessment. That is an important management advance, but gives rise to several practical questions for the general practitioner. These issues illustrate that advances in basic understanding and therapeutics have flow on research needs for practice.