The control over hypertension has been a greater challenge in the health care sector. Lack in hypertension control accounts to a lot of reasons. The prime reason accounts to the lack of adherence to the medication regime. This review article mainly discuss on the factors on which leads to the medication non adherence. Usually the complex medication schedule sites out to be the prime reason in the control of hypertension. Medication regime that has more than 3 pills have the least rate of adherence and patients who follow 1 pill regiment have higher rates of adherence. This non ability to adhere to the medications were the reasons why this research on using pacemaker to control hypertension. The pacemaker uses a particular algorithm to control hypertension by regulating the AV pumping interval. A ModeratoTM pulse generator that administers PHC therapy was implanted in patients who were recommended for dual-chamber pacing and had office systolic blood pressure (oSBP) >150 mm Hg despite stable medication therapy. A month was spent running the trail at a regular pace. PHC was activated and patients with oSOP (Office Systolic Blood Pressure) > 140 mm Hg were admitted to the study. The 3-month therapy phase, which comprised PHC therapy, was opened to patients who during the Run-In phase met the blood pressure standards for inclusion (oSBP >140 mm Hg at 2 and 4 weeks). The day PHC therapy began (time=0) was the trial's start date. The co-primary efficacy end objectives were changes in 24-hour ambulatory systolic blood pressure and oSBP between baseline and three months. As a safety measure, bad incidences were monitored. In New Hope, Pennsylvania, BackBeat Medical manufactures the Moderato System, a dual-chamber, rate-responsive pacemaker implantable pulse generator (IPG). A sequence of variable-timed, alternately shorter (20–80 ms) and longer (100–180 ms) atrioventricular intervals are used to pace the heart using PHC algorithms