Acquired Cardiovascular Disease Patients with ACHD can acquire other cardiovascular diseases such as hypertension, atherosclerotic coronary artery disease, vascular disease, stroke, and HF.S3.10-1 S3.10-3 The impact of acquired heart disease is increasing as the lifespan of patients with ACHD extends. Myocardial infarction is one of the leading contributing causes of death for late surviving adults with acyanotic CHD.S3.10-4 Major adverse cardiac events, such as HF, percutaneous coronary intervention, coronary artery bypass graft sur- gery, malignant arrhythmia, cardiac shock, and place- ment of an implantable cardioverter-defibrillator (ICD), are also quite prevalent.S3.10-5,S3.10-6 Overall, cardiovascular reasons account for approximately 77% of all deaths in patients with ACHD, with approximately half attributable to chronic HF.S3.10-7 Evaluation for acquired cardiac condi- tions is warranted in patients with risk factors, although results of testing (eg, stress perfusion studies) should account for preexisting abnormalities caused by CHD, recognizing prior interventions can mimic abnormalities otherwise suggestive of acquired heart disease.S3.10-8 In patients with ACHD, prevention and treatment of conditions predisposing to acquired cardiovascular di- sease such as diabetes mellitus, obesity, hypertension, dyslipidemia, and/or similar comorbidities are impor- tant. Given the increased risk of acquired cardiovas- cular disease with age, promoting a healthy lifestyle is important in all patients with ACHD, although there are not data demonstrating the effects of risk reduction on clinical outcomes specific to the ACHD population. Emphasizing the importance of daily physical activity according to functional capacity, and decreasing sed- Table 10. 