1) Hypertension and ischemic heart disease are major problems in Central America. Prevention strategies are poor. 2) The approaches used in the US and Europe may not be appropriate for Central America due to the loss of a distinctive Mesoamerican identity. 3) Factors like overweight, obesity, metabolic syndrome, and excessive sugar consumption have contributed to an epidemic of cardiovascular diseases in the region. Improving prevention strategies with a focus on lifestyle is needed.