The epidemic of cardiovascular disease (CVD) in the twentieth century prompted many population-based surveys. Now, a huge number of epidemiological studies provide a clear picture of the risk for CVD. Approximately 80% of CVD can be explained by smoking, high blood pressure, and deterioration of lipid and glucose metabolism, the two latter mediated through an unhealthy diet (high intake of salt, saturated fat, and refined sugar) and physical inactivity. A causal web for CVD shows that the influence is seen throughout the life course, and that ‘upstream‘ factors like socioeconomic status, health policies, and industrial influences all have a powerful impact on the more downstream parameters like lifestyle and biomarkers. This emphasizes that population-level interventions represent the most effective options for future strategies for the prevention of CVD.