Widely-accepted national evidence-based guidelines support the use of cardio-protective medications to reduce the risk of adverse consequences resulting from IHD and disease modifying anti-rheumatic medications (DMARDs) to reduce the risk of adverse consequence in rheumatic diseases. For example, numerous rigorously conducted randomized trials show that statins improve outcomes and reduce mortality in patients with established cardiovascular disease (i.e., secondary prevention), including those undergoing percutaneous coronary interventions (PCI). The use of statins and beta-blockers have been repeatedly demonstrated to be cost-effective in lowering cardiovascular event (CVE) rates, in part by their effects on cholesterol, and blood pressure, respectively. Accordingly, the most recent VA performance measures and American Heart Association guidelines encourage the use of statins in patients with atherosclerotic disease; beta-blockers in subjects with left ventricular systolic dysfunction (ejection fraction less than 40%), prior MI, or blood pressure of 140/90 or greater; and clopidogrel following any acute coronary syndrome (ACS) or PCI with stent. The rheumatology literature provides similar evidence for the benefit of DMARDs in rheumatic diseases, and guidelines strongly endorse their use.