Hypertension prevalence is estimated at approximately 30% of the adult population in Spain, using the 140/90 mm Hg cutoff. This represents a heavy public health burden when compared with other European countries, although the direct cost per person is one of the lowest in Europe. The programs implemented regionally since 1985 are presented here. As a result of them, a decade later the number of hypertensives with controlled blood pressure has increased from 10% in 1986 to 13% in 1995, and cerebrovascular mortality has steadily decreased.