Our understanding of the pathophysiology of atherosclerosis has expanded considerably during last two decades. A multifactorial pathophysiological process describes the progression at molecular and cellular levels, eventually manifesting itself as clinical disease. All these processes already begin in childhood, but clinical manifestations-e.g. coronary heart disease, myocardial infarction, or stroke-usually occur decades later in middle-age or in old age. Several reports have consistently shown the favorable effects of lifestyle changes. To improve primordial prevention, i.e. to prevent the development of risk factors, the American Heart Association released in 2010 the concept of Ideal Cardiovascular Health: the simultaneous presence of 4 ideal health behaviors (non-smoking, normal body mass index, being physically active, and a healthy diet) and 3 ideal health factors (normal total cholesterol, blood pressure, and fasting glucose).