Objective: We assessed change in the prevalence of overweight/obesity and hypertension among adult Congolese people at two different periods. Methods: In 2007-8 the prevalence of overweight/obesity and high blood pressure was assessed among 1,292 subjects (56.6% women) representing a random sample of the inhabitants of an urban Congolese community. The data were compared to previous observations in 424 participants (55.2% women) obtained in a 1983-4 survey of the same community. Age structure of the two samples was different. We therefore directly standardized the prevalence of overweight/obesity and hypertension for gender and age. We modeled the risk of hypertension in a multivariable logistic regression analysis and compared the rates of awareness and control of hypertension during both periods. Results: Crude prevalence of overweight/obesity (26.7 vs. 42.3%; P < .0001) and hypertension (21.5 vs. 30.9%; P = .0002) was higher in 2007-8. Overweight/obesity predominated among women at both periods, hypertension among men in 1983-4. Genderage directly standardized prevalence remained higher in 2007-8 for overweight/obesity [28.4(24.1-32.7)% vs. 41.3(38.8-43.7)%] and was borderline for hypertension [24.9(20-28.9)% vs. 29.7(27.4-31.9)%]. The 1983-4/2007-8 risk ratio was 0.69 for overweight/obesity (P < .0001), 0.84 for hypertension (P = .054). Awareness, treatment and control of hypertension tended to be better in 2007-8, especially among women. The risk of hypertension in multivariable logistic analysis, was greater for male gender (OR: 1.47[95% CI:1.14-1.88]; P = .0029), and increased with age (5.62[4.37-7.23]; P < .0001), overweight/obesity (2.27[1.77-2.91]; P < .0001) and pulse rate (for each 10 beats/min: 1.20[1.08-1.32]; P = .0005); the risk was 35% higher in 2007-8 (1.35;[1.01-1.80]; P = .0416). Conclusion: Our data indicate the prevalence of overweight/obesity and hypertension has increased among adult urban Congolese people; they suggest that prevention of cardiovascular diseases might require appropriate control of these conditions.