COST AND VALUE CONSIDERATIONS The growing need to consider value stems directly from the goal of achieving the best possible health outcomes with finite healthcare resources in the pri- mary prevention of CVD.S5-1 Value in healthcare can be defined as the incremental health benefits of a therapy or procedure relative to its incremental net long-term costs. The consideration of cost and value in the guideline development process supports key goals, including: 1) enhancing overall value in the de- livery of cardiovascular care and 2) involving health- care professionals in the challenging care decisions that must be made to increase value in the US health- The integration of value assessments into our na- tional guidelines involves inherent methodological chal- lenges, including: 1) variability in costs across different healthcare settings; 2) variability in costs and benefits across different patient subgroups; 3) variability over time; 4) variability in who bears the burden of the health outcome (ie, typically the individual patient) ver- sus who bears the burden of the healthcare cost (eg, often spread beyond the individual to third-party pay- ers, taxpayers); and 5) an inadequate literature base on which to render a sound, evidence-based assessment of certain specific therapies.S5-1,S5-2 There are additional challenges specific to the pre- vention realm. As described in the 2011 AHA policy statement, Value of Primordial and Primary Prevention Table 7. Best Proven Nonpharmacological Interventions for Prevention and Treatment of Hypertension* Nonpharmacological Intervention Goal Approximate Impact on SBP Hypertension Normotension Reference Weight loss Weight/body fat Best goal is ideal body weight, but aim for at least a 1-kg reduction in body weight for most adults who are overweight. Expect about 1 mm Hg for every 1-kg reduction in body weight. 