Hypertension is a common and readily modifiable risk factor for cardiovascular and cerebrovascular disease. Despite extensive clinical trial results and efforts to increase public awareness, it remains inadequately controlled in the general population. Women are particularly vulnerable. Recent data indicate both a growing prevalence of hypertension, particularly in the postmenopausal and African American populations, and significantly lower rates of adequate blood pressure control relative to men. Patient sex has an important influence on the nature of the disease, its management, and outcomes. This review will focus on sex-specific factors that contribute to hypertension in women, and current patterns and efficacy of treatment. In addition, we will highlight evidence-based options for antihypertensive treatment in women.