Cardiovascular disease (CVD) is the major cause of death and disability globally1 and affects more than 50% of men and 40% of women during their lifetimes.2 Despite remarkable scientific advances, in 2008 CVD accounted for 1 of every 3 deaths in the United States and for health care costs estimated at close to $300 billion.3 The major risk factors for CVD are well known but remain ubiquitous in populations. For example, about one-third of US adults (>75 million) have hypertension; more than 20% smoke; more than one-third (>78 million) are obese; 8% (>18 million) have diagnosed diabetes, with similar rates of undiagnosed diabetes and an additional 35% with prediabetes; 15% have high cholesterol levels; and, in the 2009-2010 NHANES survey, 46.5% (102.5 million) had at least 1 major risk factor among uncontrolled blood pressure, high cholesterol levels, and current smoking.3,4 These risk factors are also major contributors to other chronic diseases such as cancer, depression, arthritis, kidney disease, and cognitive decline.
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