THE VAST MAJORITY OF HEART FAILURE PATIENTS NEEDING TRANSPLANT, KIDNEY FAILURE PATIENTS NEEDING DIALYSIS, AND STROKE PATIENTS NEEDING REHABILITATION WOULD HAVE HAD THEIR ORIGINS IN THE ASYMPTOMATIC PERIOD 20-40 YEARS PRIOR. TWENTY TO FORTY YEARS PRIOR, SUCH PATIENTS WOULD HAVE BEGUN THEIR MEDICAL JOURNEYS WITH THESE PREVENTABLE AND TREATABLE CONDITIONS: HYPERTENSION, DIABETES, TOBACCO ADDICTION/USE, AND OBESITY. Charles Tadros, M.D. August 24, 2021 Saint Louis, Missouri