Despite recent advances in treating cardiovascular disease, many of the predisposing risk factors for heart disease are increasing in prevalence, raising concern that heart disease rates may rise in the years to come. When faced with the range of risk factors such as obesity, smoking, hypertension, hyperlipidemia, and diabetes, the clinician needs to address all components. After assessing an individual patient's global risk, the clinician should use a comprehensive risk-modifying strategy that incorporates therapeutic lifestyle changes and pharmacologic therapy. Key elements of lifestyle changes are individualized treatment plans and frequent follow-up, whereas approaches to improve medical therapy include using structured programs to increase awareness and implementation of risk-reducing medications. Improving risk factor modification requires a global approach, not only in addressing the spectrum of risk factors, but also in using the full range of strategies available to clinicians.