OBJECTIVES: To estimate 2003 point prevalence, treatment and control rates of hypertension for different age groups of primary care attendees in Germany, to examine factors associated with pharmacotherapy and adequate blood pressure control and to examine whether changes have occurred in rates of treatment and control since 2001. METHODS: Using standardized clinical diagnostic and treatment appraisal forms, blood pressure levels and patient questionnaires for 55,518 participants from the DETECT study (2003) were analyzed. RESULTS: According to physician diagnosis overall prevalence was 35.5%, according to NHANES criteria 56.0%. Among those defined by NHANES criteria, treatment and control rates were 56.0% and 20.3%, respectively. Significant predictors for receiving antihypertensive medication were: increasing age, female sex, obesity, previous myocardial infarction and the prevalence of comorbid conditions such as CHD, dyslipidemia and diabetes mellitus. Significant positive predictors of adequate blood pressure control were CHD and antihypertensive medication. Inadequate control was associated with increasing age, male sex and obesity. As compared to findings from 2001, rates of treatment and control indicate some improvement across all age groups. CONCLUSIONS: Rates of treated and controlled hypertension according to NHANES criteria in DETECT remain considerably low as compared to the rates of 2001, despite consistent indications of some improvement. Hypertensive patients with risk factors such as obesity and associated comorbidities such as CHD, dyslipidemia and diabetes were more likely to receive antihypertensive drugs in accordance with guidelines. Adequate blood pressure control was achieved in more patients with obesity and CHD, but not those with diabetes mellitus or dyslipidemia.