Risk factors established in young adulthood may persist into later life and eventually lead to CV disease. The purpose of this study was to describe the prevalence of hypertension and CV risk factors in older adolescents. School physicians examined 120 girls and 80 boys. After 5 minutes of sitting rest, BP was measured in triplicate by sphygmomanometry. BMI, serum lipids, smoking and drinking status were assessed. Hypertension, hypercholesterolemia and overweight were diagnosed according to the criteria specified in the 1996 update of the Task Force on BP treatment in Children and Adolescents (Pediatrics, 1996), the guidelines of the expert panel on lipids (Pediatrics, 1992) and the recommendations on the identification of obesity (Obes Res, 1998), respectively. Mean age (±SD) was 17.4 ± 0.8 years. Almost 25% of the subjects currently smoked with a median daily consumption of 6 (P 5-95 1-16) and 11 (2-25) cigarettes in girls and boys, respectively. The median daily alcohol consumption during the weekend was 10.7 g (1-60) in 35 girls and 30.0 g (1-150) in 52 boys. During the weekend, 24 (30%) boys and 4 (3.3%) girls had an alcohol consumption in excess of 30 g a day. 49 (41%) girls used oral contraceptives. Systolic (109 vs 118 mmHg, P<0.001) and diastolic BP (68.0 vs 70.5 mmHg, P=0.033) were significantly higher in boys. 4 (3%) girls and 5 (6%) boys had hypertension; 12 (10%) girls and 6 (8%) boys were overweighed (>25.0 kg/m2). Serum total cholesterol was significantly higher in girls compared with boys (4.50 vs 4.06 mmol/L, P<0.001). 20 (17%) girls and 7 (9%) boys had hypercholesterolemia (≤5.2 mmol/L). Overall, 50 (42%) girls and 42 (53%) boys had at least one CV risk factor, 15 (13%) girls and 16 (20%) boys had 2 risk factors, and 3 (3%) girls and 1 (1%) boys had >2 risk factors. In conclusion, in 17-18-year-olds living in an affluent society the prevalence of CV risk factors was high. These findings underscore the importance of health education and prevention at this age.