An inverse association between socio-economic status and prevalence of heart disease is observed in a number of advanced societies. Sociology can contribute to the explanation of this association by providing refined measures of social inequality and, most importantly, by developing theoretical models which predict coronary risks in terms of stressful social conditions and of vulnerability factors in individuals. After describing the social distribution of heart disease on the basis of most common measures of social inequality, this paper discusses three recent sociological models: the model of social support; the model of job strain; and the model of effort-reward imbalance. The promises and limits of these models are evaluated, and their implications for comprehensive preventive action in public health are outlined.