It addresses the primary prevention of CVD in adults ( 18 years of age), focused on outcomes of ASCVD (ie, acute coronary CLINICAL STATEMENTS AND GUIDELINES syndromes, MI, stable or unstable angina, arterial re- vascularization, stroke, transient ischemic attack, or peripheral arterial disease of atherosclerotic origin), as well as heart failure and atrial fibrillation. The guide- line presents recommendations to prevent CVD that are related to lifestyle factors (eg, diet and exercise or physical activity), other factors affecting CVD risk (eg, obesity, diabetes, blood cholesterol, high BP, smoking, aspirin use), patient-centered approaches (eg, team- based care, shared decision-making, assessment of so- cial determinants of health), and considerations of the cost and value of primary prevention. 1.5. Class of Recommendation and Level of Evidence Recommendations are designated with both a Class of Recommendation (COR) and a Level of Evidence (LOE). The COR indicates the strength of recommen- dation, encompassing the estimated magnitude and certainty of benefit in proportion to risk. The LOE rates the quality of scientific evidence supporting the intervention on the basis of the type, quantity, and consistency of data from clinical trials and other sources (Table 1).S1.5-1 Table 1. 