© 2019 Elsevier Inc. All rights reserved. The symptoms of cardiovascular diseases (CVD) generally manifest in individuals over 50 years old. The underlying causes of CVD, such as atherogenesis and atherosclerosis, usually start to develop early in life, even during childhood, according to our lifestyle choices and dietary patterns. In the clinical setting, medical doctors usually assess scores for CVD risk by using a series of biomarkers in order to decide what risk management is required. However, the evaluation of CVD risk is mostly based on traditional biomarkers derived from the ¿lipid hypothesis¿ as discussed in Chapter 4, where serum levels of cholesterol and its related plasma lipoproteins have been correlated with a higher risk for atherosclerosis and CVD. Consequently, current risk management strategies, either by dietary intervention or by medical treatment, generally only address these traditional risk markers when assessing a patient¿s health. A CVD risk score is calculated and a treatment strategy is employed using a ¿lower is better¿ approach. Although these traditional approaches to CVD risk management have dominated primary prevention practices for several decades, CVD remains the leading cause of death globally, accounting for nearly 1 in 3 deaths; it is predicted that CVD will remain the leading cause of disability in developed countries until 2020. Hence, prompt and continuous research is imperative to utilize and assess modern biomarkers for achieving higher diagnostic accuracy to predict CVD risk. Recent studies have suggested that there are other causes of atherosclerosis and CVD other than high cholesterol levels, such as underlying and unresolved chronic inflammatory manifestations due to maladaptive diet and lifestyle and various other factors. Thus, assessment of modern biomarkers related to inflammation, in combination with ultramodern metabolomics and imaging methods, seems to be a more realistic and accurate approach to decipher CVD risk. This approach is supported by the observed reduction of CVD risk through primary prevention programs and strategies that involve the adherence to healthy dietary interventions in combination with various therapies. Therefore, prevention strategies for risk management should be reevaluated and based mostly on healthy dietary patterns and lifestyle choices that can beneficially modulate both the causes and risk factors for CVD.