The association of cadmium exposure with area of residence, blood pressure, and arterial hypertensive disease was examined in 230 reindeer herders in northernmost arctic Finland. Blood cadmium concentration averaged 10.0 nmol/l, and was three times higher in smokers than in nonsmokers (16.7 vs. 5.5 nmol/l). Concentrations increased from the southwestern to the northeastern area west of the Kola Peninsula, Russia, both in nonsmokers (3.1 vs. 6.8 nmol/l) and smokers (10.8 vs. 32.0 nmol/l). High cadmium levels were most common in the northeast: 32% of the values were at least 15 nmol/l, 10% at least 45 nmol/l (health-based limit of WHO), and 3% at least 90 nmol/l (the critical limit for renal damage). High cadmium concentration was associated with a rise in blood pressure; the rise was particularly pronounced in subjects with hypertensive diseases. These associations were not affected by age, body mass index, smoking, and alcohol consumption. The results suggest that cadmium exposure may have harmful health effects in arctic Finland and emphasize the importance of reducing pollution from industrial sources in the Kola Peninsula.