Cardiovascular health programs face a growing and not often recognized challenge--the aging of the American population. During this century, all states will experience a dramatic rise in the number of older adults. By 2030, approximately 20% of Americans will be over the age of 65. This article describes the prevalence of cardiovascular disease among older adults, the public health and aging services networks, selected results and recommendations from the Aging States Project, and examples of ongoing aging activities relevant to cardiovascular health programs being promoted by the U.S. Centers for Disease Control and Prevention (CDC). State health departments (SHDs) and state units on aging (SUAs) bring different resources, approaches, and partners to address older adult health but many aspects are complementary. The aging services network is extensive, and in one form or another, can reach older adults in virtually every community in the country. Based on a survey of SHDs and SUAs, which was part of the Aging States Project, respondents identified cardiovascular disease as the most common health concern (57% of SHDs and 55% of SUAs). However, fewer than half of those responding reported having cardiovascular health programs directed at older adults (37% of SHDs and 40% of SUAs). Initial activities are described in the arenas of strategic partnerships, data for action, and capacity building based on recommendations from the survey findings. These examples are provided as potential models for current and future state cardiovascular health programs wanting to enhance their reach to older adults.