High prevalence of cardiovascular morbidity and mortality in the Russian population dictates the need to identify and prevent risk factors for these diseases from adolescence. Objective: to study the prevalence and long-term trends in cardiometabolic risk factors in an adolescent population sample of Novosibirsk (1989–2024).Methods. In 1989–2024, cross-sectional population studies of random representative samples of schoolchildren aged 14–18 of both sexes were conducted in Novosibirsk with an interval of 5 years. 8 screenings were conducted. A total of 5106 adolescents (43–46 % boys) were examined. Approval was received from the Local Ethics Committee of the Research Institute of Preventive and Internal Medicine – Branch of the Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences; all children and their parents signed informed consent for the examination. The program was uniform for all screenings and included a survey using a standard questionnaire, 2-fold measurement of blood pressure, anthropometry (height, body weight, chest, waist and hip circumferences), and a biochemical blood test for lipid profile. The levels of cardiometabolic risk factors were assessed in accordance with the latest Russian and international recommendations. Statistical data processing was performed using the SPSS for Windows 13 package.Results. The prevalence of hypercholesterolemia in adolescents in Novosibirsk over 35 years decreased from 22.3 to 3.0 % in boys and from 31.8 to 10.6 % in girls (p < 0.001). The highest prevalence of hypertension in adolescents was observed in 1989, then by 1994 its levels decreased and remained relatively stable until a decrease in 2014 with a subsequent increase, especially among boys, the prevalence of hypertension among whom in 2024 reached the 1989 level (17.3 % and 16.9 %, respectively). The greatest decrease in the frequency of excessive weight in adolescents relative to 1989 was observed in 1999: in boys – 2.7 times, in girls – 3.2 times. Since 2003, there has been a consistent increase in the prevalence of overweight among adolescents, primarily among boys, and by 2014 it exceeded the baseline values of the 1989 screening by 8 % in boys (21.6 versus 13.9 % (p < 0.01)) and by 3 % in girls (14.3 versus 11.5 % (p = 0.05)). At subsequent screenings, the frequency of overweight remained unchanged. The frequency of smoking among adolescents of both sexes decreased almost 10-fold from 1989 to 2024: from 45 % in 1989 to 5.5 % in 2024 among boys, and from 19 % to 2% among girls (p < 0.01), however, an increase in electronic smoking was noted. Over the past 5 years (2019–2024), the use of electronic cigarettes and gadgets among boys has doubled (from 6 up to 12 %) and three times among girls (from 3 to 9 %). The prevalence of reduced physical activity among adolescents remained high throughout the period, but in the last 15 years it has clearly decreased among boys (62 % in 2009 versus 37 % in 2024 (p < 0.01). Since 2009, screen time has increased: from 18 hours/week in 2009 for boys and 15 for girls to 30 hours/week in 2014 and remained at the same level in 2019. In 2024, screen time of the computer decreased, but phone time increased, which in total did not exceed the figures for 2014 and 2019 (33–35 hours/ week).Conclusions. Based on population screening of adolescents conducted in Novosibirsk over 35 years, the prevalence and long-term trends of cardiometabolic risk factors (arterial hypertension, dyslipoproteinemia, overweight and obesity, smoking and low physical activity) were identified.