Efforts to prevent cardiovascular morbid events have focused predominantly on identification of population risk factors with intervention based on the level of these risk factors. Individualised care is now possible by identification of early, asymptomatic vascular or cardiac disease likely to progress to morbid events. Intervention aimed at slowing or reversing the progression of the vascular or cardiac abnormalities can then become the therapeutic target. Since early disease commonly occurs in the absence of abnormal threshold levels of risk factors, this approach is more sensitive and specific than risk factors in matching treatment to individual risk. Preliminary data with a series of 10 non-invasive tests and a unique scoring system developed at the University of Minnesota provides a quantitative assessment of the health of the small arteries, large arteries and left ventricle. This scoring system has been shown to be remarkably sensitive in identifying the risk and time course of future morbid events. Therapy aimed at restoring vascular and cardiac health shows great promise as an individualised approach to cardiovascular disease prevention.