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Many of the mechanisms responsible for cardiovascular disease and hypertension are well known, and gender is an independent risk factor in many cohorts. How gender contributes to cardiovascular disease has not been completely elucidated. Even in normotensive populations, blood pressure is higher in men than women, although why this occurs is unclear. While both men and women suffer from high incidences of cardiovascular disease, women are typically protected against cardiovascular disease until after menopause, so that on average they are about 10 years older than men when these diseases develop, making aging a confounding problem contributing to increased morbidity. Because hypertension is one of the leading causes of cardiovascular disease in both men and women, this review will focus on hypertension, and the mechanisms that have been found to play a role in mediating blood pressure control and how they differ in men and women.