Hypertension is a complex condition affecting the cardiovascular system and has been referred to as a ‘silent killer’ because there are sometimes no obvious signs or symptoms. The prevalence of hypertension in people with learning disabilities is similar to that of the general population, so it is important that learning disability nurses understand the pathophysiology of the condition, the associated risk factors and management approaches. This article provides an overview of the cardiovascular system and the three main classifications of hypertension and associated risk factors. The authors provide guidance on taking an accurate blood pressure reading and explore the management of hypertension, including lifestyle changes and pharmacological approaches. The authors also discuss the implications of hypertension for people with learning disabilities and how nurses can support optimal cardiovascular health for this population.