Cardiovascular (CV) healthcare was established on a platform that treats end-stage disease. At the time, existent technology and knowledge could only manage evident arterial disease. The financial and intellectual commitment in this area of healthcare have resulted in astonishing accomplishments such as coronary bypass grafting, angioplasty, stents, acute antithrombotic therapies, left ventricular assistant devices, transplants, and stem cell research. The consequence has been dramatic reduction in CV mortality. Unfortunately, the incidence of end-stage arterial disease has not been significantly impacted. In addition, the price tag for these phenomenal advances in therapy has been devastating. Based on the current system of healthcare, projections for the incidence and cost of CV disease over the next decade are dismal . The current CV healthcare system is not financially sustainable . Our system must enter a new era, anchored on a platform of maintaining arterial wellness. Fortunately, we now possess the technology and knowledge to do so.