1. Two groups of hypertensive patients, randomly assigned to either physician or nurse practitioner care, were compared, after two years of follow up, with respect to diastolic blood pressure reduction and utilization and costs of medical services. In addition, satisfaction with hypertension care was evaluated. 2. There was no statistical difference in mean diastolic blood pressure reduction between the physician and nurse practitioner groups. 3. Patients in the nurse practitioner group made more visits for hypertension care than those in the physician group; thus, even though the cost per nurse practitioner visit was lower than the cost per physician visit, the total annual cost of care per patient was higher in the nurse practitioner group. 4. Patients followed by nurse practitioners were very satisfied with their care. 5. Nurse practitioners provide excellent hypertension care and thereby save valuable physician time.