We have reached a limit in our ability to reduce the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) utilising the traditional evaluation, prevention, and treatment strategies for the top 5 cardiovascular risk factors – hypertension, diabetes mellitus, dyslipidemia, obesity and smoking. Statistics show that approximately 50% of patients continue to have CHD or myocardial infarction (MI) despite “normal” levels of these five risk factors as traditionally defined. A more logical and in depth understanding is required of these top five risk factors.Mark Houston is clinical professor of medicine at Vanderbilt University Medical School, and Medical Director at Hypertension and Vascular Biology Institute and the Life Extension Institute at Saint Thomas Hospital and Medical Center in Nashville, Tennessee. He specializes in hypertension, lipid disorders, prevention, and treatment of cardiovascular diseases, nutrition, clinical age management and general internal medicine.In this interview, Dr Houston explores the next frontier in the prevention and treatment of cardiovascular disease.