Patients with established cardiovascular disease have a high risk of recurrent cardiovascular events, including myocardial infarction, stroke, and death. Secondary prevention aims to reduce the risk of this recurrent cardiovascular events. Targets for secondary prevention are specified by (inter)national guidelines, and unfortunately not often achieved. Especially lifestyle-related risk factors (smoking, overweight and physical inactivity) are hard to improve. In this thesis we evaluated the achieved secondary prevention targets in two large cohorts in the Netherlands including a multi-ethnic and a cardiac rehabilitation cohort and we found that there is room improvement. We designed a large multicentre trial, the RESPONSE 2, to evaluated the effect of a set of up to three community-based lifestyle programs to reduce the number of risk factors in patients with established coronary artery disease. At one year follow up we found a significant improvement in the intervention group. This difference was mainly determined by the higher number of patients who lost weight. Although we found that there were great differences in the amount of weight loss per individual in both the intervention as the control group.