OBJECTIVES: To assess management of cardiovascular risk factors (CVRF) in daily clinical practice and to identify areas of potential improvement in primary prevention of CVD. METHODS: A total 663 patients >50 years of age (59.4±7.6 years; 47.2% males) with at least one additional CVRF and 67 physicians (mean age: 40.7±8.6 years; 82.1% males) were included from Turkey in the multicentre, multinational, cross-sectional epidemiological EURIKA study (NCT00882336) conducted across Europe. Management and control of classical, emergent and psycho-social CVRF, use of CV risk assessment by the physicians as well as barriers for estimating and using global cardiovascular risk scores were identified. RESULTS: Total CV risk assessment in Turkish patients was stated to be performed by 48.5% of the physicians mostly by chart (71.9%) and mainly for an advice on healthy lifestyle (84.4%) and to decide on antihypertensive (78.1%) or lipid-lowering treatment (75.0%). Time constraint for global CV risk evaluation was the main reason (73.5%) for the lack of assessment identified by the physicians. A total of 514 patients (77.5%) were classified to have high CV risk by the physicians using a local (7.6%) or the recent European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (ESC 2007) (80.0%). Although global cardiovascular risk was said to be under control in 75.5% of the patients, satisfying control of CV risk factors was evident in only 56.7% while the overall percentage of the patients who were aware of their CV risk was 69.5%. CONCLUSIONS: Apparently targets defined in guidelines are not sufficiently met and there is clear need for better management of high risk patients. Development of better structured and more realistic, simple and credible national guidelines adapted to suit local medical and economic conditions should be encouraged.