Cardiovascular disease (CVD) has become the leading cause of mortality in high income countries. The leading modifiable risk factors for this remains tobacco smoking, high blood pressure, diabetes mellitus, dyslipidemia as well as air pollution. CVD has therefore come to constitute a major global medical, social and public health challenge and burden to societies at large. Responding to the CVD challenge to stem this epidemic has come to rely on a growing body of evidence generated through a range of epidemiological methods. As the need and demand for more data to drive intensified policies and action increase, it is important to understand what methods and tools are currently available, and what they bring to the field of CVD disease management and epidemiology. In this regard, the demonstrated complementarity of randomized controlled trials and observational studies has proved invaluable and here we review the contribution of cohort studies.