Attention is drawn to studies which throw doubt upon the importance of nutrition and smoking in the etiology of coronary heart disease (CHD). The main part of the review deals with psychosocial research in the field of CHD. A number of studies show that there is a clearcut association between life style, life events, social class, economic cycles, culture and CHD. The modern coronary epidemic is related to the economic boom which the US experienced during the 1940-60s and which followed a decade later in Western Europe. The later decline of CHD is related to the economic stagnation that took place in the US at the end of the 1960s. Obviously, risk factors must be seen in a cultural perspective, and the moderating effects of social support should be taken into account.