Abstract The incidence of cardiovascular disease is determined by a complex interaction of risk factors acting over the life-course. This issue can be addressed through primary and secondary prevention. Cardiovascular disease is multifactorial in origin, and a number of potentially modifiable risk factors interplay to create the phenotype susceptible. Risk factors such as age, sex, smoking, hypertension and hypercholesterolaemia have all contributed consistently to risk in numerous populations studied. In this article, we summarize the key guidelines in the prevention of cardiovascular disease and discuss strategies of risk factor modification, including reference to lifestyle measures and smoking cessation.