Cardiovascular disease (CVD) is the major cause of death in women in the USA and in the UK. The actual value of the risk factors is used to predict coronary heart disease (CHD) risk more accurately. Primary prevention should focus on the major risk factors of passive and active smoking, systolic and diastolic hypertension, elevated serum total and low-density lipoprotein (LDL) cholesterol, low high-density lipoprotein (HDL) cholesterol, diabetes, physical inactivity, and obesity. The pillars of secondary prevention are antiplatelet therapy, beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), statins, cardiac rehabilitation, a Mediterranean diet, and folic acid. Future heart attacks are prevented by the prevention of atherosclerosis or plaque formation in the coronary arteries and by the stabilization and regression of existing plaque through lifestyle modification and medication. Women must take personal preventive action to prevent CHD death and disability by working to prevent plaque formation, and promote stabilization of existing atherosclerotic disease.