Hypertension is an easily diagnosed and eminently modifiable risk factor for the development of all clinical manifestations of atherosclerosis. Despite the availability of a simple, non-invasive, and rather accurate method of measuring blood pressure (BP), and overwhelming evidence that reducing BP effectively prevents cardiovascular events, hypertension at the population level is not managed optimally. In 1997/1998 and 2000/2001, two surveys for cardiovascular risk factors were conducted in nine districts of the Czech Republic, involving a 1% population random sample aged 25-64 years in each district. In concordance with the MONICA Project, the present study confirms a high prevalence of hypertension in the Czech population, detecting an increase in prevalence for the male population over a period of 3 years (males from 38.8 in 1997/1998 to 42.3 in 2000/2001; P<0.05). Within the same period, there is also a significant increase in the awareness of hypertension in males (from 57.3 in 1997/1998 to 60.0 in 2000/2001; P<0.05), and an increase in the number of male hypertensives being treated by antihypertensive drugs (from 30.9 to 44.3; P<0.05). Control of hypertension did not change in either sex, being still suboptimal (males 16.4%, females 25.4% in the last survey in 2000/2001).