Cardiovascular diseases (CVD) are the major cause of death and a significant cause of disability in the Western world and are now threatening to impose an increasing health burden on developing nations. People with preexistent vascular disease are those at highest risk for adverse cardiovascular outcomes and require aggressive secondary preventive therapies. Large strides have been made in the development of pharmacologic agents that target atherogenesis, thus offering the ability to greatly impact on disease progression and to prevent events. Compelling data from randomized controlled trials have shown the benefits of aspirin (or antiplatelets) and angiotensin-converting enzyme (ACE) inhibitors (A), β-blockers and blood pressure– lowering agents (B), and cholesterol-lowering agents (C), particularly statins, in preventing recurrent events and improving survival. These data are the foundation for the advice for secondary prevention—the ABCs. In addition, the evidence for the central role of lifestyle factors as determinants of risk has led to increased efforts toward developing interventions aimed at modifying lifestyle patterns. Today’s biggest challenge is one of implementation. Our focus should turn to educating physicians and patients alike about available therapies and their indications and potential benefits. In addition, systematic, sustainable, and globally applicable approaches to the secondary prevention of CVD need to be developed to truly realize the vast benefits of existing therapies...