In the submitted paper contemporary mortality trends from cardiovascular diseases in Czechoslovakia are given. The author emphasizes the importance of hypercholesterolaemia and elevated LDL-cholesterol levels as the most significant risk factor for an enhanced development of atherosclerosis and for manifestation of ischaemic heart disease. In reflections on the necessity to initiate primary preventive measures the author emphasizes the importance of making use of genetic aspects when screening individuals and families suffering from familial hyperlipoproteinaemia in childhood and adult age. It is estimated that at least 5% of the entire population are affected. One of the serious aspects of the incidence of hypercholesterolaemia in the population of Czechoslovakia is that 50 or more per cent have cholesterol levels which are so high that even as an isolated risk factor they are a mild to high risk of ischaemic heart disease. The author gives an outline of a nation-wide strategy of primary preventive procedures and their incorporation into health practice.