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Analyze the impact of known and unknown hypertension on health-related quality of life (HRQOL).A descriptive cross-sectional study in the health coverage area of the Rio Hortega University Hospital, in north-western Spain, on a simple random sample of 33 022 individuals.Following a multiphase sampling, a final sample of 466 people, representative of the general population, was analyzed. The blood pressure of patients with known hypertension and those with a blood pressure of ≥ 140/90 mmHg was subjected to ambulatory monitoring in order to evaluate the degree of blood pressure control and to detect those patients with white-coat hypertension, respectively.After adjustment for sociodemographic variables, associated cardiovascular risk factors, hypertension complications and comorbidity, the patients with known hypertension presented lower scores on four SF-36 scales: physical function, general health, vitality and mental health. The group of subjects with hypertension, whether diagnosed or not, displayed a poorer HRQOL with respect to the non-hypertensive patients, solely in physical functioning and general health. Those patients with known hypertension reported more bodily pain than those subjects with unknown hypertension, while there were no differences between patients with unknown hypertension and the non-hypertensive ones.Patients with known hypertension presented a poorer HRQOL. This deterioration of the subjective state of health was not observed in patients who had not yet been diagnosed, which suggests it is due, above all, to the labeling effect and/or to the treatment more than to the hypertension per se.