Farzad Mostashari, CEO and founder of Aledade, and Sunny Kishore, Associate Professor at UCSF, join Bob Kocher for a conversation about why U.S. blood pressure control has stalled for two decades despite having the tools to do far better. Sunny and Bob recently co-authored a piece in the New England Journal of Medicine about this paradox, and Farzad launched the Million Hearts campaign to prevent heart attacks so they are uniquely positioned to break down the problem and identify solutions. The episode offers practical guidance for clinicians and patients alike: combine focused lifestyle changes with timely treatment intensification, make blood pressure visible and urgent, and treat prevention as both lifesaving and economically smart care.