Despite the fact that coronary heart (CHD) disease is the leading cause of death among postmenopausal women, research on primary prevention of CHD in women has been relatively sparse. Prevalence of CHD risk factors such as cigarette smoking and hypertension remain high among US women. Moreover, common factors unique to women including pregnancy, oophorectomy, menopause, and use of steroid hormones, appear to have an impact on CHD risk that is often poorly understood. While postmenopausal hormone therapy is increasingly recommended for the prevention of CHD, the potential impact of nonpharmacologic measures such as changes in diet, exercise, and cigarette smoking have been relatively unexplored.