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The average age of the population of Western countries is increasing. Demographic data show that in the United States, for example, 35 million people are now 65 years of age and older, and this number will double in 2030 (Figure 1). Although data from epidemiological studies have discovered that lipid levels, diabetes, sedentary lifestyle, and genetics are risk factors for cardiovascular diseases (CVDs) such as atherosclerosis, hypertension, congestive heart failure, and stroke, advancing age confers the major risk. This article first describes the development of the atherosclerotic lesion in the context of the emerging role of inflammation, then reviews some of the epidemiological data that support the notion that aging is the major risk factor for atherosclerosis. Finally, it summarizes the age-associated changes within