The arterial wall changes detected by ultrasound are the end result of all risk factors (exogenous, endogenous and genetic) known and unknown and are better predictors of risk than any combination of conventional risk factors. However, ultrasound cannot be used in people younger than 45 because characteristic changes occur after this age. Nevertheless, it can be used in individuals over 45 to identify the genetic risk factors associated with atherosclerosis. The identification of genetic factors will subsequently provide a means of identifying individuals at risk at an early age, even childhood. In addition, knowledge of the genetic abnormalities associated with increased risk in a particular individual will provide a means of targeting prophylactic therapy.