Atherosclerosis affects 7 million patients and causes approximately 50% of all deaths in the United States. A reduction in modifiable risk factors (especially smoking, hypertension and hypercholesterolemia) is associated with a 30% reduction in acute coronary events. Clinically, fewer than 25% of patients achieve this degree of risk reduction because of significant barriers to implementation of effective risk reduction programs and wide variance in the management of hypercholesterolemia.