Previous studies have shown that care for hypertension in clinical practice is not optimal. This study consists of a review of medical records of 101 hypertensive patients enrolled in a community prepaid health care project, in which all direct costs to patients are eliminated and in which patients are known to have geographical access to care. The results show that even under such conditions, there are deficiencies in what is done in the diagnosis and management of hypertension (process of care). Furthermore, recorded blood pressures in the medical records indicate that 34% of identified patients had diastolic pressures greater than 95 mm Hg at the time of last visit for hypertension.