A few settings to check -
-Lower or disable Anti Aliasing (all stages of it,ie.x1,x2,x3,x4)
-Same for Anisotropic Filtering as OLC said
-Enable Trilinear Filtering if you only have Bilinear enabled
-Enable Geometry Instancing (if your card supports that option)
-TOTALLY remove 'wait for vertical refresh' setting,as this forces your games to display screen fps (frames per second) at the same refresh speed as your monitor,irrespective of whether the game can refresh at higher rates.
- Get the latest driver update for your graphics card
- Try and get the latest Direct X version from Microsoft (to the nearest month I mean,not just Direct X 9c,you want the latest monthly update).I noticed by getting this a lot of my games actually had about a 10% performance increase.
Just for the record my card is a Sapphire ATI X800 Pro (256MB) , and still performs well against many high end cards today.I love Sapphire ATI family of cards,never had anything else really