Screening apparently healthy individuals using sensitive techniques for identifying early vascular and cardiac disease provides the opportunity for effective intervention to prevent or delay the occurrence of cardiovascular events which represent the most common cause of morbidity and mortality in our society. Preliminary studies have revealed an incidence of over 50% of early disease in need of therapy. The apparent ineffectiveness of the health care system to uncover this early disease emphasizes the need for a more aggressive community approach to screen for early disease and to initiate therapy that should reduce health care costs and improve quality and duration of life.