High blood pressure is undoubtedly the major modifiable risk factor for cardiovascular disease (CVD). However, despite advances in management, it remains inadequately managed. Across Europe, only about one in four of treated patients achieve guideline-recommended targets for blood pressure. This has important consequences for increasing the risk of CVD, kidney disease, microvascular disease, as well as potentially, dementia, Alzheimer’s disease and Parkinson’s disease. Failure to address this problem is a key contributor to the cost of CVD in the European Union community, currently estimated at €192 billion annually. In times where financial restraint is essential, urgent action is needed.