As people age, cardiovascular structure and function change and this is superimposed on by specific pathophysiologic disease mechanism. In addition to lipid levels, diabetes, sedentary lifestyle, and genetic factors that are known risks for coronary disease, hypertension, and stroke - the quintessential cardiovascular (CV) diseases related to atherosclerosis within our society - advancing age unequivocally confers the major risk. (Fig. 1) Mortality due to cardiovascular disease is more than any other disease and creates enormous costs for the health care system. The main underlying problem in cardiovascular disease is atherosclerosis, a process that obstructs major arteries with lipid deposits and cell accumulation. Decreased kidney function (estimated GFR < 70 mL/min/1.73 m2) is an independent risk factor for cardiovascular disease and all-cause mortality in the general population.