Cardiovascular disease remains the leading cause of death for all Americans despite improvements in prevention, detection, and treatment. Cardiovascular disease is no longer thought of as a disease that primarily affects older men. It is a killer of people in the prime of life with at least half of all deaths occurring in women. The risk factors for cardiovascular disease present in both non-modifiable and modifiable forms. Lifestyle measures represent a particularly potent way of lowering modifiable risk factors for heart disease because many lifestyle measures affect multiple risk factors. The identification and management of cardiovascular health risk factors in individuals is an important goal in primary care and community settings. This paper reviews the risk factors for cardiovascular disease, presents an analysis of the Coronary Health Improvement Project program as an educational and behavioral modification tool to improve risk factors, and recognizes the critical role of primary care practitioners in educating and counseling patients about how to manage lifestyle issues associated with cardiovascular risk.