The objective of this study was to determine the prevalence of carotid atherosclerosis in black Cameroonian adults presenting cardiovascular risk factors (CVRF). It was based on 77 subjects over the age of 40 years (50 men and 27 women) with at least one major CVRF, such as hypertension (HT), smoking, dyslipidaemia or diabetes mellitus. Obesity [body mass index (BMI), waist/hips ratio (W/H)] and hyperuricaemia were also taken into account. Duplex ultrasound examination of the carotid arteries was performed with a Siemens apparatus equipped with a 7.5 MHz transducer array. An atheromatous plaque was defined as medio-intimal thickening > or = 1.5 mm, with either protrusion or hyperechogenicity. Risk factors were distributed as follows in our serie: HT: 82%, Obesity: 49% (W/H) and 32% (BMI); Diabete: 32%; Smoking: 23%; Hyperuricaemia: 21%; Hypercholesterolaemia: 13%. 19 subjects (25%) (12 men and 7 women with a mean age of 63 years) presented one or more atheromatous plaques in the carotid arteries. Hyperuricaemia and hypercholesterolaemia were significantly correlated with the presence of plaques, with a marked tendency in subjects over the age of 70. In this study, hyperuricaemia and advanced age appeared to be independent arterial risk factors on multivariate analysis. In conclusion, our data show that carotid atherosclerosis does exist in our populations, especially in elderly subjects with cardiovascular risk factors. The particular role of hyperuricaemia as a predictive factor of atheromatous plaques in black Cameroonian subjects needs to be defined.