The exceptional growth in risk factor assessment and the efficacy of primary prevention in childhood of atherosclerotic and hypertensive diseases is the subject of entire books that have recently collated the results of multiple investigators (58, 59). It is a topic well beyond the constraints of this review. It appears that the major "adult" CHD risk factors, including elevated total plasma and low-density lipoprotein cholesterol, elevated triglyceride, reduced high-density lipoprotein cholesterol, high blood pressure, obesity, and initiation of cigarette smoking can usually be recognized in children. There are, as yet, no longitudinal studies that control for one or more of these CHD risk factor variables to determine whether future development of CHD could be prevented or ameliorated. In the absence of unequivocal longitudinal studies of efficacy of intervention, prudent, safe, and well-supervised interventions should be carried out only after exhaustive proof of diagnosis (58). The recently summarized data suggest that they hyperlipoproteinemias, high blood pressure, obesity, and initiation of cigarette smoking can (with varying degrees of success) be dealt with during childhood and adolescence.