Non-communicable diseases, particularly cardiovascular diseases (CVD) and metabolic syndrome (MS), remain a major challenge for primary health care (PHC). This study aimed to assess cardiometabolic risk and health behaviours in adult PHC patients using routine preventive screening. This prospective observational study included 506 adults attending routine consultations in an urban PHC centre in Poland. Preventive assessment included anthropometric measurements (body weight, height, BMI, and waist circumference), blood pressure, lipid profile, and fasting glucose levels. Health behaviours were recorded using the standardised NFZ CHUK questionnaire. The 10-year CVD risk was estimated using the SCORE2 algorithm. Multivariable logistic regression was used to identify independent factors associated with high cardiovascular risk (SCORE2 ≥ 5%) and of a composite endpoint defined as the presence of any non-optimal biochemical parameter. Nearly half of the participants had excess body weight (overweight or obesity), and more than half met criteria for central obesity. Borderline or elevated total cholesterol was found in 47% of patients, abnormal LDL in 27%, low HDL-C (<40 (84% (age, (bmi (≥5%) 0–1 1.2% 12%. 25.7% 30 4–5 80% 9% a abnormalities accumulated activities additionally additionally, age, also analysis. and applying approximately as associated at attainment biochemical cardiovascular clustering cohort. components cut-offs), diabetes dl) early educated educational enable even expected, factor factors factors, factors. fasting focus from glucose high high-risk higher highly identification impaired implementation important in included increased individuals interventions.< kg least lifestyle lipid lower m2)—a male marker. mg models, modifiable multivariable non-optimal not obesity observed of on one or p patients phc population. predicted presence prevalence preventive priority proportion relatively remain risk risk, risk. routine score2 score2—was screening sex, sex-specific should smoking) systematic the therapeutic those timely to univariate was were, when with young, ≥>