Objective: To determine the impact of low-dose estrogen oral contraceptives (OCs) on lipid profile, blood pressure, and glucose in black and white women in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Methods: Two thousand two hundred seventy-one black and white women, 18 to 30 years of age, were recruited from 1985 to 1986 from the populations of 4 cities. They were re-examined every 2 to 3 years through 1992 and 1993 (retention rate, 81%). Data were collected on OC use, cigarette smoking, alcohol use, physical activity, weight and diet, blood pressure, fasting blood lipid profiles, and insulin. Results: Adjusted triglyceride levels in both ethnic groups increased over 7 years to a greater extent in women who began OC use than compared with other women: the mean increase was 20.2 mg/dL (SE 4.6) in black women and 32.6 mg/dL (SE 5.6) in white women (both P < .0001). Black women who began OC use had a mean increase in systolic blood pressure (SBP) of 3.4 mm Hg (SE 1.5), and those who quit had a decrease of 0.6 mm Hg (SE 0.9) (P < .01). Patterns of OC use were not consistently associated with diastolic blood pressure, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), or insulin levels. Restricting the analysis to women using only combination OCs with less than 50 μg of estrogen did not change the results. Conclusions: Low-dose estrogen OCs as currently prescribed in community settings are associated with increased triglyceride levels and, to a lesser degree, SBP levels. Copyright © 2001 by W.B. Saunders Company.