Reducing the continued high burden of cardiovascular disease (CVD) morbidity, disability, mortality, disparities, and costs remains a paramount public health goal for communities and countries. Accelerating favorable population trends in cardiovascular health behaviors and factors and reversing adverse trends can be expected to extend further the reduction of recent decades in overall CVD mortality.1 Effective community-wide interventions can be replicated and scaled up to maximize their population health benefit. From this perspective, the report from Record and colleagues2 in this issue of JAMA is an important contribution, describing 4 decades of experience in CVD prevention in Franklin County, Maine.2