Cardiovascular disease (CVD) affects nearly half of US adults over the age of 20 and remains the leading cause of morbidity and mortality worldwide. The distribution, onset, and progression of risk factors vary across the lifespan and show important sex-specific patterns. Women experience steeper midlife increases in blood pressure, menopause-related shifts toward more atherogenic lipid profiles, and distinct exposures during reproductive years, including hypertensive disorders of pregnancy, gestational diabetes, preterm delivery, and hormonal contraceptive use. These factors intersect with traditional risk determinants such as hypertension, dyslipidemia, diabetes, and obesity, as well as behavioral and social determinants of health that influence risk trajectories. This chapter synthesizes epidemiologic and clinical evidence on traditional and sex-specific CVD risk factors, highlights differences in pathophysiology and risk expression between men and women, and outlines current guideline-based approaches for risk assessment from childhood through late adulthood to inform targeted prevention and management strategies.