Background: Atherosclerosis is known to be almost silent by remodeling, but it presents as clinical disease with stenosis, which is associated with subclinical plaque rupture. To understand the role of risk factors on vascular stenosis, we evaluated the relationship between angiographic stenosis and risk factors in patients with atherosclerosis. Method and Results : From 2000 to 2003, we analyzed coronary angiogram from 970 patients.The patients with 50-70 % stenosis were excluded to reduce biases(n=180) and 790 patietns were compared in relation to risk factors such as DM, hypertension, smoking, hyperlipidemia, and obesity. The score of risk factor in patients with over 70 % focal stenosis (n=378, M:184, 58.7 yr) was higher than in those with mild diffuse lesion(20-50%)(n=172, M:86, 55.2) or normal coronary artery (n=240, M:116, 54.2)(1.83짹0.96, 0.82짹0.59, 0.84짹0.70, p<0.001). There is a good relationship between number of focal stenosis and an increasing score of risk factors (Figure). In multivariate logistic regression analysis, DM was most strongly related with multiple focal stenosis (��� 3 focal stenosis) (Odd ratio 4.414, P<0.001) among risk factors (obesity OD=2.711, Hypertension OD=2.613, Hyperlipidemia OD=2.593, smoking OD=2.531, all P<0.001). Conclusion : The number of focal stenosis was strongly related to incidence of cardiovascular risk factors, especially DM. This finding suggests that the role of cardiovascular risk factor is related to development of vascular stenosis rather than atherosclerosis per se.