Reviewer Relationships With Industry and Other Entities (Comprehensive) e158 PREAMBLE Since 1980, the American College of Cardiology (ACC) and American Heart Association (AHA) have translat- ed scientific evidence into clinical practice guidelines (guidelines) with recommendations to improve cardio- vascular health. These guidelines, which are based on systematic methods to evaluate and classify evidence, provide a cornerstone for quality cardiovascular care. The ACC and AHA sponsor the development and pub- lication of guidelines without commercial support, and members of each organization volunteer their time to the writing and review efforts. Guidelines are official policy of the ACC and AHA. Intended Use Practice guidelines provide recommendations applica- ble to patients with or at risk of developing cardiovas- cular disease. The focus is on medical practice in the United States, but guidelines developed in collabora- tion with other organizations may have a global impact. Although guidelines may be used to inform regulatory or payer decisions, their intent is to improve patients quality of care and align with patients interests. Guide- lines are intended to define practices meeting the needs of patients in most, but not all, circumstances and should not replace clinical judgment. Clinical Implementation Guideline recommended management is effective only when followed by healthcare providers and patients. Adherence to recommendations can be enhanced by shared decision making between healthcare providers and patients, with patient engagement in selecting interventions based on individual values, preferences, and associated conditions and comorbidities. Methodology and Modernization The ACC/AHA Task Force on Clinical Practice Guidelines (Task Force) continuously reviews, updates, and modi- fies guideline methodology on the basis of published standards from organizations including the Institute of and on the basis of internal reevaluation. 