The British Hypertension Society Guidelines published last year were widely welcomed as a major step forward in the management of patients with high blood pressure. In common with all recent guidelines they were based on a review of all relevant evidence, mainly gained from clinical trials. However, medicine is never static and research is ongoing. A major study – ASCOT – has provided new information about the benefits of newer combinations of antihypertensives compared to older drugs. What did the study show and how should we act on the results to improve outcomes for our patients?