Once on optimal therapy, no need to recheck lipids routinely ii. If the answer is No to Box 4, then Box 6, in the shape of a hexagon, asks the question: Does patient have CVD per Sidebar 1, DM, or LDL 190 mg/dL? 1) If the answer is Yes to Box 6, then Box 7, in the shape of a rectangle: Recommend moderate-dose statin (see Sidebar 3) 2) If the answer is No to Box 6, then Box 8, in the shape of a hexagon, asks the question: Is patient s 10-year CVD risk >12%? a) If the answer is Yes to Box 8, then Box 7, in the shape of a rectangle: Recommend moderate-dose statin (see Sidebar 3) b) If the answer is No to Box 8, then Box 9, in the shape of a hexagon, asks the question: Is patient s 10-year risk 6 12% and does patient prefer statin treatment? i) If the answer is Yes to Box 9, then Box 7, in the shape of a rectangle: Recommend moderate-dose statin (see ii) If the answer is No to Box 9, then Box 12, in the shape of a rectangle: Recommend regular aerobic exercise (Suggest regular aerobic activity of any intensity or duration. Although incremental benefit is associated with increased doses of physical activity, lower doses including leisure time activity [i.e., walking, landscaping, washing dishes] are associated with benefit when compared to mostly sedentary behavior. A provider s considerations when recommending physical activity might include a patient s motivation, functional capacity, and physical activity preferences.) and smoking cessation (if applicable) (1) Box 12 connects to Box 13, in the shape of a rectangle: Follow up evaluation: 1. Primary prevention, no statin: Lipids every 10 years, recommend non-fasting; Repeat risk evaluation at If risk factors change. 2. 