Abstract : Hypertension, a global health problem with around 7. 5 million deaths attributed to it. This amounts to 12. 8% of annual deaths worldwide. 9 The graph is expected to rise, covering 1.56 billion adults with hypertension in 2025. 10 The prevalence is significantly higher in geriatric population. This accounts for 57 million DALY (disability adjusted l ife years) or 3 .7 % of total DALYs. To assess hypertensive patients presenting to the ER and OPD for non-specific ST- T wave changes in ECG. To document their presentation BP, symptomology, medical co- morbidities (diabetes) along with age and gender. To do 3 month follow up to assess the persistence of the NSSTTWC and the BP control of these patients and progression of symptomology. Present study is a prospective study carried among hypertensive patients aged greater than 18 years presenting to the ER and OPD. Sample size is 248. Baseline characteristics are recorded and they are followed for 3 months. Again all the symptoms and ECG are recorded. Among 248 patients only 12% had non- specific ST-T wave variations in ECG. As per Minnesota code classification system, 10% belonged to C 1 category, 17% belonged to C 2 category and 73% belonged to C 3 category. Those who are diabetic are at more risk of having abnormal ECG changes compared to non -diabetics. The association is statistically significant (P=0.009). There is statistically significant association between uncontrolled systolic blood pressure and Non-specific ST -T wave changes (NSSTTWC) among study participants on presentation and after 3 months (P=0 .0001). Symptomatically palpitation is the most statistically significant (P=0.0001) complaint on presentation and follow-up patients with associated NSSTTWC. The study demonstrates a substantial link between the NSSTTWC and uncontrolled blood pressure. This in turn increases the risk of cardiovascular events as elucidated in previous studies. Diabetics are more prone to developing NSSTTWC due to uncontrolled blood pressure. Palpitation is the most statistically significant complaint in association with NSSTTWC.