Preventive cardiology as a dedicated clinical service: The past, the present, and the (Magnificent) future

•Ischemic cardiovascular disease continues to be most common cause of death after age 55 everywhere in the world.•As the average person is exposed over life to a variety of artery-damaging insults it is easy to predict that this trend will continue for decades.•We face an unprecedented opportunity to consolidate, strengthen, and broaden the effort to prevent cardiovascular events, both ischemic and non ischemic.•This effort requires professional lifestyle counseling, dietary interventions, use of natural supplements, pharmacotherapy, and efficient cross-referral strategies.•The nascent subspecialty of preventive cardiology must reach uniformity in protocols of care, and must develop a system of training and certification for the next generation of expert providers.