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Introduction: When Hmong refugees arrived in the U.S. from 1975 to 1997, no epidemiological studies measured the prevalence of or development of cardiovascular diseases (CVD) (such as hypertension and diabetes) or CVD risk factors (such as obesity, high blood pressure, and high cholesterol). Some recent studies on convenience samples estimated prevalence rates as: overweight 49%, obesity 31%, hypertension 18-24%, and diabetes 13-40%. This study measured the prevalence of CVD and CVD risk factors in Hmong refugees recently arrived from an unofficial refugee camp at War Tham Krabok (WTK), Thailand. Methods: Cross-sectional descriptive epidemiological study of 1462 Hmong refugees from WTK who received refugee screening exams at seven primary care clinics in St. Paul MN, from June 2004 to December 2005. Results: Significant percents of adults and children/adolescents had CVD risk factors. Of 448 people >20 years old, 48.2% were overweight or obese (BMI >=25). Using Asian BMI, 71.7% were overweight or obese (BMI >=23). Also, 16.5% had hypertension (BP-systolic > 140 or BP-diastolic >90) and 36.2% had pre-hypertension (BP-systolic 120-139 or BP-diastolic 80-89). For a subset, 2.8% had diabetes mellitus (glucose >200), 31.7% had hyperglycemia (glucose 100-199), 25.8% had hyperlipidemia (total cholesterol >200), 7.4% had renal failure (GFR7.5 female, >8.2 male). For 988 people 0-20 years old, 13.7% were overweight and 9.6% had hypertension. For a subset, 20.7% had hyperglycemia, and 13.% had hyperlipidemia. Conclusion: Hmong refugees had significant CVD risk factors on arrival, and are at risk for developing significant CVD over time. Community health programs need to be implemented to decrease the development of CVD for the Hmong community, whether people arrived in 1975-1997 or 2004-2005. And an epidemiological study measuring CVD incidence needs to be conducted. [ABSTRACT FROM AUTHOR]