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To assess the trends in blood pressure levels and hypertension control in Finland from 1982 to 1997.Four independent cross-sectional population surveys conducted in 1982, 1987, 1992 and 1997.From 1982 to 1997, the provinces of North Karelia and Kuopio in eastern Finland and the region of Turku-Loimaa in southwestern Finland were surveyed. From 1992 to 1997, the Helsinki–Vantaa region in southern Finland was surveyed.Men and women aged 25–64 years were selected randomly from the national population register. The total number of participants was 27 623.We assessed mean systolic and diastolic blood pressure, prevalence of hypertension (subjects with systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 95 mmHg or current use of antihypertensive drug treatment) and antihypertensive drug treatment and quality of hypertension care among hypertensive persons.Mean systolic blood pressure and the prevalence of hypertension decreased significantly in all areas except among men in the Helsinki–Vantaa region. The fall in mean diastolic pressure was significant only in eastern Finland. The proportion of hypertensives who were unaware of their condition fell from 45.5 to 24.1% in men and from 27.2 to 15.7% in women. At the same time, the proportion of hypertensives with adequately controlled blood pressure (systolic pressure < 160 mmHg and diastolic pressure < 95 mmHg) increased from 9.4 to 23.5% in men and from 16.0 to 36.7% in women.Hypertension care in Finland has improved significantly during the last 15 years. However, the situation is still far from optimal. It is obvious that the biggest problem in hypertension care has shifted from detection to adequate treatment of high blood pressure.