Hypertension and hyperlipidemia as (usually asymptomatic) risk factors contribute to the progression of cardiovascular diseases since younger adulthood (40 years). These patients are exposed to these risk factors for a long time resulting in accumulation of atherosclerotic damage.
Early diagnosis and intervention of these factors together with communication with the patient about the risk have the impact on the occurrence of cardiovascular events. We present the case of a 62-year old smoker with acute myocardial infarction and left ventricle dysfunction who has been refusing the pharmacotherapy of hyperlipidemia and hypertension for 20 years.