There were an estimated one million deaths from cardiovascular disease in sub-Saharan Africa in 2013. The deaths can in some part be prevented through the control of risk factors for coronary artery disease. The major modifiable risk factors in adults include: smoking, obesity, unhealthy diet, dyslipidaemia, hypertension and diabetes. This article aims to discuss the primary prevention of coronary artery disease through examining the evidence regarding the control of these modifiable risk factors. It also briefly explains a pragmatic approach to the use of aspirin as primary prevention for coronary artery disease which takes into account both the risks and benefits associated with aspirin use.Keywords: cardiovascular risk factors, primary prevention, aspirin therapy, dyslipidaemi