Introduction: In recent years, the dominance of cardiovascular diseases as a major contributor to total mortality globally was observed. Standardized death certification rates for cerebrovascular disease in Bulgaria in the age group 0-64 were about six times higher than in England in 1994. Methods: This study is based on a sample of 3100 people aged 25 - 74. Subjects were invited to their local polyclinics where anthropometrical indices and blood pressure were measured, a blood sample drawn and questionnaire administered. Results: Means and proportions for ages 35 – 64 standardised to the world standard population, were for males and females respectively: Systolic blood pressure – 132 mmHg and 129 mmHg, Diastolic blood pressure – 86 mmHg and 85 mmHg, Total serum cholesterol – 5.0 mmol/l and 5.0 mmol/l, Body Mass Index – 26.2 kg/m2 and 25.8 kg/m2, regular smokers - 36% and 29%. Conclusions: The risk factor findings offer little explanation for reported mortality trends. Repeated surveillance studies will be needed and for these, greater attention will need to be given to achieving and maintaining quality in data collection.