In the United States, cardiovascular disease is the leading cause of death in men over 50 years old and in women over 55. Nearly one million Americans will die of heart disease this year; 2,400 will die each day of cardiovascular disease, an average of one death every 36 seconds. Clearly this is an area that is of concern to each of us. In recent years, many risk factors which favor the development of cardiovascular disease have been reported. These include a family history of premature coronary artery disease, tobacco smoking, hypertension, diabetes, obesity, and most famously, elevated cholesterol levels. Most patients are interested in knowing how high their cholesterol is and want to get it as low as possible. And while there is nothing wrong with that, it is now clear that there are factors other than cholesterol which can lead to cardiovascular disease. As many as 50% of people who have their first heart attack have a normal level of cholesterol. So there are clearly other issues at play. Important, but lesser known risk factors in the development of heart disease, are inflammation, infections, diet, and lifestyle. Many people have heard of CRP (C reactive protein), which is a marker for inflammation in a person's body. An elevated CRP is an important risk factor for heart disease, and reducing an elevated CRP can reduce the likelihood of a heart attack even more so than lowering cholesterol. A typical American diet rich in saturated fats and high glycemic foods, as well as tobacco use, obesity, and insulin resistance, can cause the CRP be elevated. Chronic hidden infections in the body can also raise the CRP level. Infections which have been linked to the development of cardiovascular disease include periodontal gum disease, respiratory infections including influenza, stomach infections (H Pylori) and even urinary infections. Addressing each of these factors can lower CRP and thus the risk of heart disease. Interventions to lower CRP include dietary modification, the use of Omega 3 fatty acids (fish oil), exercise, treating chronic infections, aspirin therapy, and statin drugs, which not only lower cholesterol but also reduce inflammation. For many people, lifestyle and nutritional interventions can substantially reduce cardiovascular risk even without the use of more aggressive pharmacological treatments. Though the heavily marketed cholesterol lowering drugs can be life saving, there are other important safe and effective ways to reduce the risk of heart disease.