This review briefly summarises the scientific evidence for the child's future risk of ischemic heart diseases (IHD). The conventional risk factors such as dyslipidemia, hypertension, diabetes and smoking can not account for all the cases of cardiovascular diseases. Therefore other risk factors such as fibrinogen, homocysteine, paraoxonaze and abnormality in antioxidant defence systems are included. Among the lipids parameters the level of lipoprotein (a) and increased plasma cholesterol, specifically LDL-cholesterol may be used as a marker of family history of IHD and hypercholesterolemia. Additionally, low level of HDL-cholesterol is also related with endothelial dysfunction and increased oxidative stress. It has been hypothesised that free radicals mediate in the development of IHD and that antioxidants play a protective role in prevention of this pathology. Many of the major risk factors can be modified through diet, body mass control, exercise and (if necessary) through pharmacological intervention. Therefore, the efficacious prevention should be related with the early detection of risk factors particularly in children with familial dyslipidemia, hypertension and IHD.