The kidneys are inextricably interwoven with high blood pressure (BP). Hypertension is called the silent killer in the lay media precisely because it is asymptomatic for the vast majority. An underappreciated aspect of the management of hyper tension is proper BP measurement. Inaccurate measurement will result in inappropriate treatment. Modern home BP devices use an oscillometric technique, and are cheap and easy to use. Variability is variably defined based on the time frame. Short-term variability refers to that seen on a 24-hour Ambulatory blood pressure monitoring whereas long-term refers to visit-to-visit variability. Masked hypertension deserves a separate mention since it follows, as a corollary of improper BP measurement, that it is underrecognized and potentially undertreated. Thiazide diuretics are the oldest class of BP lowering drugs which are still first-line agents. Device therapy has shown some promising results in recent years, but it is far from being ready for clinical use yet.