Cardiovascular disease is the leading cause of death world-wide in populations older than 65 years of age. The variation in cardiovascular mortality rates in this population indicates a substantial potential for effective coronary prevention. The highest risk for development of coronary heart disease is in individuals older than 65 years of age; many of the risk factors for coronary disease are modifiable, such that an older population may benefit substantially from a preventive program aimed at reducing coronary heart disease. The promotion of cardiovascular health at elderly age requires emphasis on the adoption of healthy lifestyles and the use of pharmacologic intervention when appropriate.