With an aging population, cardiovascular disease (CVD) prevalence will continue to increase for at least the next 30 years. Current clinical trial evidence expands the indications for aggressive treatment of risk factors. Concurrently, the use of new screening and diagnostic technologies will expand the number of identified high-risk individuals requiring clinical care. These likely scenarios will force efficient resource allocation. The impression of the authors is that new models of shared responsibilities of care are needed to enable CVD prevention. All stages of care for those with CVD should entail cooperation among nurses, pharmacists, primary care providers, and cardiovascular specialists in delivering comprehensive, evidence-based care. The persistent treatment gap between current knowledge and clinical practice suggests old models of acute patient care by specialists require revision into fundamentally different systems of long-term care by a team of providers such as that proposed by the Chronic Care Model.