Cardiovascular diseases (CVD) and coronary heart disease (CHD) still remain as the main cause of death and disability both in men and women in Europe.The role of major cardiovascular risk factors in CHD and CVD development has been shown to be fairly similar in both sexes.The effectiveness of preventive risk factor modifications for CVD is well established in large clinical trials, and the effect has been shown in both sexes.The European Society of Cardiology (ESC) has established guidelines on cardiovascular prevention aiming at an equal preventive action in men and in women.Recent studies have shown slower CHD incidence and mortality decline among younger, middle-aged women in Europe.The reasons for the lower mortality decline among younger, middle-aged women are not clear.Studies have suggested that clinical manifestations ofischaemic heart disease in women may be different from those commonly observed in males.This may account for under-recognition of the disease.Moreover, women are likely to be referred for diagnostic tests at a more advanced stage of disease, and are less likely than men to have corrective invasive procedures.Also the use of thrombolysis in acute stage of myocardial infarction in less in women than in men.Furthermore, there is robust evidence that high cardiovascular risk is not always recognized in women and treated effectively enough.Conclusions: It appears that the high risk situation is not always recognized and treated adequately in younger women.There is substantial gender-specific differences in treatment both pharmacologically and interventionally.The most effective means of decreasing the impact of CVD on womens health is proper principles of healtheare in order to modify the contribution of specific risk factors.