Background and Objectives: Little is known about the association between dietary patterns and cardiovascular disease risk factors among Japanese adults based on nationally representative data. This study aimed to explore the association between dietary patterns and hypertension or blood lipid profiles among Japanese people. Methods and Study Design: De-identified Japan National Health and Nutrition Survey (NHNS) 2012 data with a total of 8721 subjects (3524 men and 5197 women) aged 40-74 years were used. Dietary patterns were derived by principal component analysis (PCA). Generalized linear models and multivariate logistic regression analysis were used to assess the relationship between dietary patterns and blood pressure or lipid profiles. Results: We identified four dietary patterns: (a) traditional Japanese, (b) bread-dairy, (c) meat-fat, and (d) noodle patterns. Among these, the traditional Japanese pattern was significantly related to lower blood pressure, lower low-density lipoprotein (LDL)-cholesterol in men and lower high-density lipoprotein (HDL)-cholesterol in women. Bread-dairy pattern was associated with high total cholesterol in women and higher LDL cholesterol in both men and women. Noodle pattern was associated with higher total cholesterol and HDL-cholesterol in men. No significant association was observed between meat-fat pattern and blood pressure or lipid profiles. Conclusions: Our study showed that the traditional Japanese pattern with high intake of miso, soy-sauce, vegetables, beans, potatoes and mushroom conferred benefits on blood pressure. Our findings have indicated clearly that it is possible to provide useful information on healthy dietary pattern for health promotion from the one-day dietary records of the NHNS.