The aims of investigations were to assess the prevalence of arterial hypertension (AH) among Latvian population aged > or = 45 years and to evaluate the current AH management situation in Latvia. Four epidemiological databases (Dbases) for analyses were selected: Dbases of a randomized urban population of Riga city (in 1997) and Kuldiga region (in 2000), a Dbase of the DIASCREEN population selected by high risk to diabetes from those visiting family doctors (in 2003) and a Dbase of a Latvian population selected from those visiting family doctors during 3 days in 2005. The prevalence of AH in the urban population was 41.8 +/- 1.4% (with 61.2% for persons over age 45), in rural population 40.5 +/- 1.6% (with 63.7% for those aged above 45). Therapeutic control of AH for patients over 45 years with regular medicine intake differed significantly in three samples of the population analysed: Riga 7.2 +/- 2.7%, Kuldiga 9.9 +/- 1.6% and DIASCREEN 6.4 +/- 0.8%. The addition of another risk factor decreases the control rate, especially in a combination of AH and overweight. The most widely prescribed drugs are angiotensin-converting enzyme inhibitors (ACEI) 31%, diuretics 21% and beta-blockers 20% of patients. AH control rate in the case of monotherapy with ACEI was 6.9 +/- 0.9%, calcium antagonists 5.6+1.2%, beta-blockers 12.5+2.0% and diuretics 3.8+1.4%. The current status of management of hypertension in Latvia is discussed.