This paper seeks to explore the impact of social and cultural factors upon perceptions of the patients' cardiovascular risk and intended lifestyle changes. Qualitative and quantitative research approaches were used. The sample was purposeful; matched groups of 10 first time post myocardial infarction (MI) patients, 10 informal (spouse, blood relative or partner) and 10 formal carers (nursing staff) were selected on a convenience basis. Personal interviews were conducted with participants, during which a semistructured questionnaire was completed. A combination of descriptive statistics and qualitative analysis of these data revealed that social and cultural factors formed the basis of patients' and informal carers' perceptions of cardiovascular risks and social information networks provided the main source of information about cardiovascular risk. For the staff, known risk factors based on epidemiological evidence (lack of exercise and diet) formed the basis of their perceptions of the patients' cardiovascular risk factors. However, for all the participant groups (i.e. patients, informal carers and staff) the risk factors - diet and exercise were indicated as being the patients' intended lifestyle changes., The results illustrate potential interplay between 'social' and 'cultural' context and perceptions of cardiovascular risk and incongruency between perceptions of risk and perceptions of the patients' intended lifestyle change. These results may assist nurses in giving effective advice to patients and relatives about lifestyle change following myocardial infarction and inform future policy for cardiac rehabilitation.