Quality of life on antihypertensive therapy is an important consideration because clinicians are asked to initiate drug therapy and follow mostly asymptomatic patients for long periods of time on agents that are fairly equivalent in both blood-pressure-lowering capacity and the reduction of adverse clinical events. There is, however, evidence to show that hypertension is not always an asymptomatic condition; therefore, the reduction of blood pressure makes people not previously knowledgeable of their hypertensive state feel better. Labeling a patient hypertensive may have negative quality-of-life consequences. Clinicians need to be well informed regarding side-effect profiles as well as anxiety conditions that may lead to subjective complaints that are blamed on medication. Additionally, medication information given to patients may have an important effect on adverse effect reporting. Specific intolerance profiles to the thiazides, angiotensin-converting enzyme inhibitors, beta blockers, calcium channel blockers, and angiotensin receptor blockers are discussed in this review. Medication compliance requires a multi-tiered strategy. Low-dose thiazide is well tolerated.