Therefore, clinicians may consider the use of another risk prediction tool as an alternative to the PCE if the tool was validated in a population with charac- teristics similar to those of the evaluated patient. Examples include the general Framingham CVD the Reynolds risk scores,S2.2-56,S2.2-57 SCORE (Systematic COronary Risk Evaluation),S2.2-58 and the QRISK/JBS3S2.2-59 tools. Other professional societies have incorporated some of these alterna- tive validated risk scores into their lipid manage- ment guidelines or have considered different risk thresholds for preventive interventions.S2.2-58 S2.2-63 Although slight differences exist across organi- zational guidelines, they are all very similar in their overarching goal of matching the intensity of preventive therapies to the absolute (generally 10-year) risk of the patient.S2.2-58 S2.2-63 2. After age 20 years, it is reasonable to mea- sure traditional risk factors at least every 4 to For adults 20 to 39 years of age, limited data exist on the performance and utility of Because age is a major driver of risk, most in this age range (<40 years) are unlikely to have a sufficiently elevated 10-year risk to warrant pharmacological therapy with a statin (with some exceptions, such as in familial hypercholesterolemia). Nevertheless, peri- odic assessment of risk factors (eg, at least every 4 to 6 years in younger adults 20 to 39 years of age) is important to guide discussions about inten- sity of lifestyle interventions, frequency of risk factor monitoring, treatment of nonlipid risk fac- tors, and consideration of 30-year or lifetime risk 3. No single risk calculator is appropriate for all patients. 