It addresses the primary prevention of CVD in adults ( 18 years of age), focused on outcomes of ASCVD (ie, acute coronary syndromes, MI, stable or unstable angina, arterial revascularization, stroke, transient ischemic attack, or peripheral arterial disease of ath- erosclerotic origin), as well as heart failure and atrial fibrillation. The guideline presents recommendations to prevent CVD that are related to lifestyle factors (eg, diet and exercise or physical activity), other factors af- fecting CVD risk (eg, obesity, diabetes, blood choles- terol, high BP, smoking, aspirin use), patient-centered approaches (eg, team-based care, shared decision- making, assessment of social 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). Table 1. Applying Class of Recommendation and Level of Evidence to Clinical Strategies, Interventions, Treatments, or Diagnostic Testing in Patient Care (Updated August 2015) CLINICAL STATEMENTS AND GUIDELINES The COR indicates the strength of recommendation, encompassing the estimated magnitude and certainty of benefit in proportion to risk. 