The relationship among potential risk factors (diet, adiposity, physical activity levels (PALs), and age) for elevated blood pressures (BP) was examined in 253 Sherpa men living in Kathmandu (low altitude sample: LAS) and in the Khumbu (high altitude sample: HAS) regions of Nepal. The study is based on data collected to assess nutritional status. Elevated BPs were highly prevalent among both samples of men (LAS: 21.7% and HAS: 24.8%). The highest percentage of elevated BP was found among the urban HAS (32.4%), while rural HAS had the lowest percentage (16.1%). Stepwise regression analyses showed that the BMI, age, and alcohol consumption were strong predictors of systolic blood pressure (SBP), and the BMI and age were strong predictors of diastolic blood pressure (DBP). No correlations were found among BP and intakes of sodium, calcium, potassium, or fat when all men (normotensive and elevated BP) were examined. Bivariate association between the BMI and BP showed that obese men were 8.6-9.1 times more likely to have elevated BP, and that alcohol consumers were 2.6 times more likely to have elevated BP. The results suggest that elevated BP is a problem for a large portion of male Sherpas and appears to be associated with an elevated BMI. A survey of the region only 30 years ago showed no cases of hypertension. Increasing adiposity, due primarily to decreasing PALS, places this population at risk of chronic illness in the future. Am. J. Hum. Biol. 11:469-479, 1999. Copyright 1999 Wiley-Liss, Inc.