CLINICAL STATEMENTS AND GUIDELINES Recommendations for Adults With High Blood Cholesterol Referenced studies that support recommendations are summarized in Online Data Supplements 11 and 12. COR LOE Recommendations I A In adults at intermediate risk ( 7.5% to <20% 10-year ASCVD risk), statin therapy reduces risk of ASCVD, and in the context of a risk discussion, if a decision is made for statin therapy, a moderate-intensity statin should be recommended.S4.3-2 S4.3-9 Adapted from recommendations in the 2018 Cholesterol Clinical Practice Guidelines.S4.3-1 I A year ASCVD risk) patients, LDL-C levels should be reduced by 30% or more, and for optimal ASCVD risk reduction, especially in patients at high risk ( 20% 10-year ASCVD risk), levels should be reduced by 50% or Adapted from recommendations in the 2018 Cholesterol Clinical Practice Guidelines.S4.3-1 I A In adults 40 to 75 years of age with diabetes, regardless of estimated 10-year ASCVD risk, moderate-intensity statin therapy is indicated.S4.3-11 S4.3-19 Included from recommendations in the 2018 Cholesterol Clinical Practice Guidelines.S4.3-1 I B-R In patients 20 to 75 years of age with an LDL-C level of 190 mg/dL ( 4.9 mmol/L) or higher, maximally tolerated statin therapy is Included from recommendations in the 2018 Cholesterol Clinical Practice Guidelines.S4.3-1 IIa B-R In adults with diabetes mellitus who have multiple ASCVD risk factors, it is reasonable to prescribe high-intensity statin therapy with the aim to reduce LDL-C levels by 50% Included from recommendations in the 2018 Cholesterol Clinical Practice Guidelines.S4.3-1 Figure 3. Primary prevention. Colors correspond to Class of Recommendation in Table 1. ABI indicates ankle-brachial index; apoB, apolipoprotein B; ASCVD, atherosclerotic cardiovascular disease; CAC, coro- nary artery calcium; CHD, coronary heart disease; HIV, human immunodeficiency virus; hs-CRP, high-sensitivity C-reactive protein; LDL-C, low-density lipoprotein cholesterol; and Lp(a), lipoprotein (a). 