However, I do have a big problem with the amount of industry money that is involved in so much of our research and guidelines. The AHA takes millions of dollars a year from pharmaceutical companies and I think it would be a mistake to overlook the impact that large sums of money have on decisions. That is not to say that any of the many incredible individuals involved in the development of these guidelines have done anything but fantastic work. I don’t think that this is an issue of individual conflicts of interest. Money, however, can have subtle effects. We know that even accepting gifts as small as pens can leave medical students feeling beholden to drug companies. I think there is ample evidence that the influence of money on medical guidelines and research in general is clearly detrimental.