Our findings that the initial improvements in guideline adherence were sustained over time are in accordance with the experiences gained from the follow-up study of the Get With The Guidelines–Coronary Artery Disease program,13 in which it was shown that initial improvements in guideline adherence for 6 measures (aspirin at arrival and discharge; β-blocker at arrival and discharge; angiotensin-converting enzyme inhibitor for left ventricular systolic dysfunction; and smoking cessation counseling) were sustained over 3 consecutive annual measurements. This evidence concerns the gene ACE and coronary artery disorder.