BACKGROUND: Risk factors in young adulthood may persist into later life and eventually lead to cardiovascular (CV) disease. The purpose of this study was to describe the prevalence of hypertension and other established CV risk factors in older adolescents. METHODS: Study nurses examined 120 girls and 80 boys with a mean age of 17.4 (SD, 0.8; range 15.8-19.6 years). After 5 minutes of sitting rest, resting blood pressure (BP) of the participants was measured in triplicate by sphygmomanometry. Body height and weight were measured and body mass index (BMI) was calculated. Serum lipids, smoking and drinking status were assessed. Hypertension was diagnosed according to the criteria specified in the 1996 update of the Task Force on BP treatment in Children and Adolescents (Pediatrics 1996;98:649-58). RESULTS: Almost 25% of the subjects currently smoked with a median daily consumption of 6 (Interquartile 4-9) and 11 (6-16) cigarettes in girls and boys, respectively. Fourty-nine (41%) girls used oral contraceptives. Systolic (118 versus 109 mm Hg, p<0.001) and diastolic BPs (70.5 versus 68.0 mm Hg, p=0.033) were significantly higher in boys than in girls. Two (2%) girls and four (5%) boys had systolic hypertension; diastolic hypertension was found in six (5%) girls and one (1%) boy. Twelve (10%) girls and six (8%) boys were overweight (>25.0 kg/m2). Twenty (17%) girls and seven (9%) boys had hypercholesterolemia (total serum cholesterol > or =5.2 mmol/L). Overall, 50 (42%) girls and 31 (39%) boys had at least one CV risk factor, 12 (10%) girls and four (5%) boys had two risk factors, and three (3%) girls and one (1%) boy had more than two risk factors. CONCLUSIONS: In 17-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.