Despite significant modern-day advances in healthcare, cardiovascular disease (CVD) remains the number one killer in the United States and throughout the world. Many who do not succumb to a heart attack or stroke are left debilitated, and likely to experience a future event. The financial burden of CVD is significant and on the rise. The numbers of procedures and invasive surgeries performed to manage advanced disease are staggering. Primary care providers are well-positioned to initiate risk-reduction therapies, but many times fail to do so. Discussions about risk factors and treatment options are far-too often neglected. Better identification and management of at-risk individuals is needed in the primary care setting. Strategies should target patients and providers.