The Supporting Hypertension Awareness and Research Europe-wide (SHARE) survey aimed to qualify the key challenges that physicians face when trying to get patients to recommended blood pressure (BP) goals. The survey was open to physicians involved in the treatment of hypertension, was anonymous, and included 45 questions covering: physicians' demographic information, familiarity with BP treatment guidelines, views on the BP targets recommended by the 2007 European Society of Hypertension and European Society of Cardiology (ESH-ESC) guidelines, and perceptions on the proportion of 'challenging patients' in hypertension management (defined as patients not achieving the BP goal, where the BP goal is at least <140/90 mm Hg, and <130/80 mm Hg for patients with co-morbidities or high CV risk). Physicians significantly underestimated the proportions of their 'challenging patients' with hypertension compared with their perceptions of the proportions achieving 2007 ESH-ESC BP targets (p < 0.0001). The majority of cardiologists (75.5%) and general/family practitioners (GPs) (81.3%) as well as internists (59.3%) (p < 0.05 for cardiologists and GPs vs internists) felt that it was a challenge to get their patients to target BP, stating that only 43.2%, 57.4% and 38.2% of their patients, respectively, achieved these targets in practice (p < 0.05 for GPs vs cardiologists and internists). Physicians may underestimate the proportion of 'challenging patients' with hypertension and there is a need to improve their BP control. Increasing physicians' awareness about the risks of uncontrolled BP and improving compliance are two possible ways to improve management of hypertension.