The erythrocyte Na-Li countertransport (CT) has been considered as a marker of genetic propension to essential hypertension, but also to be linked to atherosclerosis risk factors. We have evaluated these relationships by measuring the Na-Li CT, blood pressure levels, the family predisposition to hypertension, body mass index, subscapular skin-fold thickness, waist/hip ratio, and plasma lipids in 43 young adults (22 to 23 years; 13 with a positive family history of hypertension), followed since adolescence (+/- 10 years) to analyze the natural history of blood pressure in this period of life. The Na-Li CT was negatively correlated with the HDL cholesterol (r = -0.37) and the HDL cholesterol/total cholesterol ratio (r = -0.44). This transport system was positively correlated to family history of hypertension (r = 0.38), waist/hip ratio, and the diastolic blood pressure. When the family history of hypertension was present, Na-Li CT and diastolic blood pressure were higher W <. 05), but the HDL cholesterol was lower W < .01). After separating people according to the blood pressure level during adolescence in two groups, one lower than the 75th percentile (P75), and one higher, we notice that the latter remains characterized by a higher systolic blood pressure. But neither the Na-Li CT nor family history of hypertension and plasma lipids could explain the difference in the blood pressure behavior during this period. Thus, an increase of RBC Na-Li CT activity in young adults would suggest a higher cardiovascular risk rather than to be a simple marker of a hypertensive risk.