Described herein is a gene therapeutic approach to the prevention and treatment of vascular disease and coronary heart disease; in particular, atherosclerosis. The inventive methods may be used in the prevention and treatment of atherosclerosis, as well as any disease or physiological condition in which atherosclerosis plays a role. The inventive methods involve the gene delivery of ApoA-I or ApoA-IMilano. This may be accomplished by the use of rAAV technology. rAAV virions may be delivered to a mammalian subject by various methodologies, including transplantation of transduced bone marrow cells, direct intramuscular injection, intravenous or portal vein injection or stent delivery.