Cardiovascular disease continues to be the leading cause of death in the United States. Several risk factors for heart disease are genetically based. Two of these risk factors are familial hypercholesterolemia and hyperhomocysteinemia. Effective and relatively inexpensive treatments have been established for these risk factors. This article reviews the genetic basis for familial hypercholesterolemia and hyperhomocholesteinemia, presents strstegies for diagnosis and treatment, and discusses implications for nursing practice.