Numerous studies had shown that lifestyle modifications canreduce the risk for subsequent coronary events or death in patientswith pre-exiting coronary heart disease (CHD). Stoppingsmoking, regular physical activity and making healthyfood choices are an integral part of total risk management inpatients with CHD. We evaluated gender differences in lifestylecomponents of secondary prevention for CHD (smokingstatus, physical activity and dietary fat intake) in patientswith established CHD. This prospective trial included 130randomly selected patients from Family Medicine TeachingCenter Tuzla (66 men and 64 women), aged 40-80 years,with established CHD. We determined smoking status in allparticipants and assessed dietary fat intake by using modifiedDietary Intake Nutrition Evaluation method (DINE). We assessedintensity of physical activity in all participants by usingBorg scale for perceived exertion. Mean age of participantswas 64.9 ± 7.8 years; 28/130 patients were daily smokers(22%), while 60/130 patients were ex-smokers (46%). Morethan one third of patients had never smoked (32%), with significantlymore women than men (p = 0.003). Mean dietaryfat intake was 35.4 ± 6.0 g/day; 59/130 patients self-reportedregular physical activity (45%). Mean intensity of physical activitywas 9.3 ± 1.6 and significantly higher in men than inwomen (p = 0.002). Results of this study showed unhealthylifestyles in patients with coronary heart disease that indicatesthe need for more effective intervention by primary careteams to change behavior and modify lifestyles in order toreduce risk for recurrent coronary events.