Many potential "new" risk factors may predispose to atherosclerotic diseases. The most promising currently seem to be fibrinogen, C-reactive protein and other inflammatory markers; hyperhomocysteinemia; low vitamin E intake; insulin resistance; lipoprotein(a); and fetal undernutrition. However, clinical trial proof of a causal role between several of these risk factors and CHD may be difficult to obtain unless selective interventions are developed to lower them. Certainly, current emphasis for primary and secondary prevention needs to focus on the established risk factors, particularly those for which clinical trial evidence has demonstrated interventions are efficacious for CHD prevention.