Evidence that cardiovascular (C-V) risk factors are identifiable in childhood and are predictive of future C-V risk is now irrefutable. That levels of C-V risk factors track or persist over time is important, since such phenomenon confers a life-long burden of C-V risk and indicates subtle and progressive changes in the C-V system. C-V risk factors occur often in constellation and central obesity and the attendant insulin resistance/hyperinsulinemia underlie the comorbid conditions of dyslipidemia, hypertension, thrombosis, and inflammation, among others. Autopsy studies and non-invasive subclinical C-V imaging studies in youth clearly link the multiple risk factor burdens to adverse C-V system changes. The application of multiple risk factors profiling in young individuals in conjunction with non-invasive measurements of vascular changes can promote successful aging and encourage preventive cardiology beginning in early life.