OBJECTIVES: Cardiovascular risk factors remain poorly controlled across Europe despite clinical guidelines. The European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA) investigated the use of cardiovascular risk assessments tools and guidelines, and explored factors limiting their use. METHODS: Physicians (n=806) from 12 European countries answered questions regarding their work setting, their assessment of patients with cardiovascular risk factors, and their use of risk calculation tools and clinical guidelines. RESULTS: Participating physicians worked in primary care centres or outpatient clinics; 63.8% were GPs. The majority (69.3%) reported using global risk calculation tools. Written charts were the preferred method (69.9%), followed by software (33.0%). The most popular tools were SCORE (European Society of Cardiology [ESC]; 52.4%), Framingham (16.9%) and the European Hypertension Chart (31.3%). Reasons for not using risk tools included time constraints (60.8%), not being convinced of their utility (22.1%) and lack of knowledge (20.0%). A high percentage of physicians believed the algorithms have limitations (72.4%); 92.1% believed they lead to overlooking other risk factors and 69.3% believed they cannot be used to calculate risk in elderly patients. The most commonly used clinical guidelines were those from the ESC (CVD Prevention in Clinical Practice [56.3%] and Management of Arterial Hypertension [29.9%]) or from local authorities (17%). In total, 12.9% of physicians reported not using guidelines; reasons included the wide choice or uncertainty of which to use (47.5%), time constraints (33.7%), lack of knowledge (27.7%) and a perception that they are unrealistic (23.8%).    CONCLUSIONS: Time constraints, perceived utility and inadequate knowledge were common factors limiting the use of cardiovascular risk evaluation tools and assessment guidelines. Better compliance with risk assessment tools may reduce the high proportion of patients with poorly managed cardiovascular risk factors.