Aims: To evaluate the cost of illness from hypertension for the Italian National Health System (NHS), Methods and Results: A prospective analysis was carried out on clinical and economic data recorded in the general practitioners' (GPs) database, Twenty-one GPs working in the Ravenna area in Italy took part in the project on a voluntary basis. The study included 1047 hypertensive patients enrolled between 1 June and 31 December 1997 and continued for 365 days from the date of enrolment, The following costs were calculated: antihypertensive drugs, laboratory tests and instrumental procedures, GP visits for blood pressure control, specialist visits, casualty visits, hospitalisation due to cardiovascular problems. In the whole sample, the most relevant cost is due to antihypertensive drugs (42.7%), followed by hospital admission (28.4%), GP visits (15.1%) and tests (10.6%), The total mean cost was significantly lower in incident (no previous treatment) than in prevalent patients (already treated) (457 512 vs 725 573 Italian Lira (ITL), P < 0.05) and in older rather than in younger patients (1171 410 vs 796 452 (ITL) P < 0.05), (In the text the equivalent is given in Euros, Pounds Sterling and US dollars). Conclusion: Our study should be considered as preliminary, nevertheless it could represent a step towards the evaluation of the true cost of hypertension.