Magnitude of the Problem IHD remains a major public health problem nationally and internationally. It is estimated that 1 in 3 adults in the United States (about 81 million) has some form of cardiovascular disease, including .17 million with coronary heart disease and nearly 10 million with angina pectoris.26,27 Among persons 60 to 79 years of age, approximately 25% of men and 16% of women have coronary heart disease, and these figures rise to 37% and 23% among men and women $80 years of Although the survival rate of patients with IHD has been steadily improving,28 it was still responsible for nearly 380 000 deaths in the United States during 2010, with an Although IHD is widely known to be the number 1 cause of death in men, this is also the case for women, among whom this condition accounts for 27% of deaths (compared with 22% due to cancer).30 IHD also accounts for the vast majority of the mortality and morbidity of cardiac disease. Each year, .1.5 million patients have an MI. Many more are hospital- ized for UA and for evaluation and treatment of stable chest pain syndromes. Beyond the need for hospitalization, many patients with chronic chest pain syndromes are temporarily unable to perform normal activities for hours or days and thus experience a reduced quality of life. Among patients enrolled in the BARI (Bypass Angioplasty Revascularization Investi- gation) study,31 about 30% never returned to work after coronary revascularization, and 15% to 20% of patients rated their own health as fair or poor despite revascularization. 