Latin America is a region with more than 40 countries and almost 650 million inhabitants who mostly share a Hispanic heritage, speak Latin languages, and have cardiovascular diseases (CVD) as the leading cause of death. However, there are significant differences in the prevalence of CVD risk factors and prognosis. Socioeconomic disadvantages, including less access to education, are important determinants of those differences, both between and within countries; the poor and less-educated individuals face an increased risk due to a higher prevalence of sedentarism, smoking, obesity, hypertension, and diabetes, but also have less awareness of disease and limited access to health care, that leads to an increase in incidence and mortality from CVD. Regional initiatives following WHO directions have been implemented in most countries, mainly for the control of smoking, obesity, and hypertension, leading to an overall reduction in age-adjusted CVD mortality, but with marked differences between countries. Additionally, some clinical trials have shown the benefits of complex interventions, addressing several aspects of CVD risk factor controls, but they are still waiting for proof of widespread implementation. Any initiative should address the socioeconomic disadvantages to improve health and equity.