Lipid-lowering therapy has been advocated as a means to decrease the incidence of cardiovascular disease. The basis for this are results of animal studies, epidemiologic surveys, and intervention studies in man. There have been recommendations by national and international advisory boards regarding the aims and means of such interventional strategies. These have not been unanimously accepted, however. The present article will review the evidence on which intervention strategies may be based and the current status of the scientific discussion. The implications for future strategies to prevent atherosclerosis are discussed.