Letswalo BP, Schmid-Zalaudek K, Brix B, et al. - This cross-sectional cohort investigation was carried out among adolescents from a low socio-economic rural area in South Africa, to determine cardiometabolic risk factors as well as early indicators of vascular dysfunction among them. Participants included 244 adolescents (188 females) of African ancestry aged 13–16 years. In rural South African youth, there was a high prevalence of overweight/obesity and hypertension. The risk for developing cardiovascular disease (CVD) was present in almost half of the examined adolescents. Experts identified a high link between cardiometabolic risk factors and pulse wave velocity, which further indicates that CVD progression in adulthood may be promoted by hypertension in adolescents. There is an urgent necessity for early identification of those carrying the risk and execution of prophylactic strategies in underprivileged young people in order to terminate the progression of vascular damage as well as manifestation of CVD in rural African children.