Despite decades-long improvement, recent evidence suggests that rates of myocardial infarction, stroke, and other cardiovascular disease (CVD) events have plateaued and are increasing among certain groups, including adults aged 35 to 64 years.1,2 These events are common, costly, and largely preventable. Million Hearts, a national initiative co-led by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS), was launched in 2012 with a 5-year aim to prevent 1 million acute cardiovascular events by improving key CVD risk factors. Projections using 2012-2014 data suggest that an estimated 500 000 events may have been prevented by 2016,3 although improvement in risk factors was slow. To accelerate progress, Million Hearts 2022 began in 2017 with new and refreshed partnerships and a strengthened framework. This Viewpoint reflects 2 recent CDC reports that together highlight the challenges and opportunities to improve the nation’s cardiovascular health.