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Objective: Adults with hypothalamic-pituitary disease have increased morbidity and mortality from cardiovascular disease (CVD). Therefore, the prevalence of CVD and adequacy of treatment of cardiovascular risk factors (according to current treatment guidelines) was studied in a large group of patients with hypothalamic-pituitary disease. Study design: In 2005, 152 consecutive adult patients with hypothalamic-pituitary disease attending our neuro-endocrine centre were clinically examined and blood pressure (BP), lipid profile, type 2 diabetes mellitus, body composition and smoking status were assessed. Results: Of the 152 patients, 36.8 % had treated hypertension and 28.2 % had treated dyslipidaemia. Many of these patients had inadequate BP control (BP.140/85 mm Hg, 44.6%) and undesirable lipid levels (total cholesterol.4.0 mmol/l, 69%). Also, many of the untreated patients had BP and lipid levels which should have been considered for treatment (26 patients (27%) and 83 patients (76%), respectively). Smoking was admitted in 18 % of patients. Central adiposity was present in 86 % and obesity (body mass index>30) was present in 50%. Conclusions: Cardiovascular risk factors are highly prevalent and often inadequately treated in adult patients with hypothalamic-pituitary disease. Aggressive treatment of these factors is essential to reduce mortality an