Coronary heart disease (CHD) is the major cause of death in women. Because the manifestation of CHD differs in women and men (men are more likely to have acute CHD and women are more likely to have chronic CHD), it is imperative to explore the unique aspects of CHD in women. In addition, there is a critical need to increase our understanding of the effect of CHD risk factor modification on coronary morbidity and mortality in women. Several major CHD risk factors in women, such as elevated blood lipids and lipoproteins, body weight, and, frequently, hypertension, are beneficially responsive to nutrition intervention. Approximately 27% of all women and 50% of women aged 55 to 74 years are candidates for dietary intervention. The fact that women respond positively to dietary intervention has been well established by researchers. Studies are needed to determine the efficacy of risk factor modification achieved by dietary and other hygienic approaches as well as by other more rigorous therapies (eg, drugs and surgery) on the primary and secondary prevention of CHD in women. Finally, it will be important to understand the effects of gender, menopausal status, and age on dietary responsiveness. We must gain a better understanding of these issues so that we may significantly reduce the incidence of CHD in women.