Atherosclerosis develops at an early age. We studied whether cholesterol metabolism in adolescence is related to coronary risk factors later during the adult years. A random population sample of 12-year-old (n=162), 15-year-old (n=158), and 18-year-old (n=148) boys who participated in the Cardiovascular Risk in Young Finns Study was studied for major coronary risk factors in 1980 and 2001. These values were related to noncholesterol sterols and their quartiles in 1980 (ie, markers of cholesterol absorption and synthesis). In 1980, serum triglycerides, body mass index (BMI), and systolic blood pressure were lower and high-density lipoprotein (HDL) cholesterol was higher in high absorbers versus low absorbers. This difference, except HDL cholesterol, was maintained after follow-up (eg, in 2001, systolic blood pressure was 123+/-1 mm Hg in low absorbers vs 119+/-1 mm Hg in high absorbers, P