BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of mortality globally and in Poland. This study assessed the prevalence and trends of cardiovascular (CV) risk factors in the Polish population over time. METHODS: Data from 705,399 individuals aged 35-55 years enrolled in a CVD prevention program (2012-2021) were analyzed. Risk factors included smoking, hypertension, dyslipidemia, low physical activity, overweight, obesity, and elevated glucose. Sex-specific differences and time trends were evaluated. RESULTS: Smoking prevalence decreased significantly in men (36-27.29%, p < 0.001) and women (24-17.98%, p < 0.001). Hypertension was more prevalent in men (17.45-19.62%) than women (6.84-8.58%), with significant curvilinear change over time (p < 0.01). Elevated total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) declined significantly (-3.29, p < 0.001; -3.11 [mg/dL], p < 0.001, respectively). Low physical activity remained prevalent (> 75%), while overweight and obesity affected more men (49.45% and 24.69%) than women (31.67% and 17.12%). Mean glucose levels rose slightly (p = 0.045). Mean SCORE values decreased significantly over time (p < 0.001). CONCLUSIONS: Improvements in smoking prevalence, TC, LDL-C, and SCORE values reflect progress in reducing cardiovascular risk factors. However, persistent physical inactivity, overweight, and rising glucose levels highlight the need for intensified preventive efforts targeting metabolic and lifestyle risk factors.