Given the importance of risk factor management to long-term outcome following coronary artery bypass grafting (CABG) and the paucity of information on risk factor changes in women, a study was undertaken to examine the coronary risk factor status of women before and 1 year after CABG. This study was a prospective investigation of 130 women who underwent first-time, isolated CABG between February 1992 and October 1993. Lipid profiles, blood pressure, weight, smoking status, and other lifestyle behaviors were measured at the time of surgery and again 12 months later. The sample was 24% African American and had a mean age of 65 years and an average of 11 years of education. Substantial favorable changes in risk factor status occurred in the prevalence of smoking and the number of cigarettes smoked per day among smokers. Although the women experienced weight loss, 58% continued to be obese, and the self-reported dietary intake of fat, saturated fat, and cholesterol remained above the recommended levels of the National Cholesterol Education Program's Step II diet. Mean systolic and diastolic blood pressures significantly increased, and a substantial number of patients (54%) continued to exhibit hypertension at 1 year. No significant changes in plasma lipid concentrations were observed. At 1 year, one third of the women exceeded recommended levels for triglycerides, 78% for total cholesterol, and 92% for low-density lipoproteins. These findings indicate that women continue to have multiple coronary risk factors after CABG, putting them at high risk for future coronary heart disease events. Healthcare professionals need to target these women for effective secondary prevention.