OBJECTIVES: Despite the availability of the ESC European guidelines on cardiovascular prevention, considerable cardiovascular mortality remains throughout Europe. The European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA) (NCT00882336) investigated the prevalence and degree of control of main cardiovascular risk factors in primary prevention of cardiovascular disease (CVD). METHODS: EURIKA was a cross-sectional study conducted simultaneously in 12 European countries (n=809 primary care and specialist physicians). Patients aged ≥50 years who were free of clinical CVD, but had at least one risk factor as defined by the 2007 European guidelines on cardiovascular prevention, were eligible for inclusion. Data recorded included smoking status, body mass index, cholesterol levels, blood pressure and presence of diabetes. Cardiovascular risk was assessed by Systematic COronary Risk Evaluation (SCORE) methods. Attributable coronary mortality was calculated based on our prevalence estimates together with hazard ratios for CVD-related mortality (from the Third National Health and Nutrition Examination Survey). RESULTS: In total, 7641 patients (mean age: 65 years; 48% male) were evaluated. Of those aged <65 years, 27% had a SCORE-based absolute risk of CVD of ≥5%. The prevalence of risk factors was 21.3% for current smoking, 71.9% for hypertension, 55.4% for dyslipidemia, and 26.6% for diabetes. Control of risk factors among patients receiving therapy was 49% (between country range: 40–61%) for hypertension, 48% (26–74%) for dyslipidaemia and 40% (26–54%) for diabetes. The adjusted excess mortality attributable to risk factors was 17% (14–25%) for current smoking, 23% (21–25%) for hypertension, 26% (17–31%) for dyslipidaemia, and 30% (20–37%) for diabetes. CONCLUSIONS: The prevalence of traditional cardiovascular risk factors is high and their control is suboptimal. Traditional risk factors such as hypertension, dyslipidaemia and diabetes are responsible for a large fraction of the estimated coronary deaths that could be avoided through primary prevention.