The purposes of this study were to determine whether there is a significant correlation between the perceived and actual stroke risk among hypertensive patients and to identify patient characteristics associated with inaccurate estimation of stroke risk. The authors performed a cross-sectional analysis of 296 men with hypertension who were enrolled in the Veterans Study to Improve the Control of Hypertension (V-STITCH). A patient's actual stroke risk was calculated using the Framingham stroke risk (FSR); patients' perceived risk was measured according to a self-reported 10-point risk scale. The median 10-year FSR was 16%, but the median perceived risk score was 5 (range, 1 [lowest] to 10 [highest]). There was no significant correlation between patients' perceived risk of stroke and their calculated FSR (Spearman rho=-0.08; P=.16; 95% confidence interval, -0.19 to 0.03). Patients who underestimated their stroke risk were significantly less likely to be worried about their blood pressure than patients with accurate risk perception (12.4% vs 69.6%; P<.0001). The lack of correlation between hypertensive patients' perceived stroke risk and FSR supports the need for better patient education on the risks associated with hypertension.