With cardiovascular disease as the leading cause of death in the United States, the topic of preventive cardiology deserves intense examination. Michael Rich and George Mensah guest edit this issue, which explores important topics, such as the burden of cardiovascular disease, updates on hypertension, hyperlipidemia, and diabetes, all geared towards the elderly patient. This issue of Clinics in Geriatric Medicine also covers the effects of physical activity on cardiovascular and non-cardiovascular outcomes, impact of strength and resistance training on cardiovascular risk factors and outcomes, cellular mechanisms and the effects of caloric restriction, obesity and the obesity paradox, and the primary and secondary prevention of cardiovascular diseases in older adults.