Patients should know their current cardiovascular risk and how it relates to decisions about their therapy. Observational studies have demonstrated that ASCVD risk factors frequently occur in combination, with 3 risk factors present in 17% of patients.141 A meta- analysis from 18 cohort studies involving 257384 patients identified a lifetime risk of ASCVD death, nonfatal MI, and fatal or nonfatal stroke that was substantially higher in adults with 2 ASCVD risk factors than in those with only 1 risk factor.141,142 To facilitate decisions about preventive interventions, it is recommended to screen for traditional ASCVD risk factors and apply the race- and sex-specific PCE (ASCVD Risk Estimator139,140 ) to estimate 10-y ASCVD risk for asymptomatic adults 40 75 y of age.59,139,140 For management of blood cholesterol, adults should be categorized as having low (<5%), borderline (5% to <7.5%), intermediate ( 7.5% to <20%), or high ( 20%) 10-y risk.143 The PCEs are best validated among non-Hispanic whites and non-Hispanic blacks living in the United States.19,144 147 In other racial/ethnic groups148,149 or in some non- the PCE may over- or under-estimate risk. Therefore, clinicians may consider use of another risk prediction tool, as an alternative to the PCE, if validated in a population with similar characteristics to the evaluated patient. Examples include the general Framingham ASCVD risk score,152 Reynolds risk scores,153,154 tools. Other professional societies have incorporated some of these alternative validated risk scores into their lipid management guidelines or have considered different risk thresholds for preventive interventions.155 160 Although slight differences exist across organizational guidelines, they are all very similar in their overarching goal of matching the intensity of preventive therapies to absolute (generally 10-y) risk of the patient.155 160 Clinical Recommendations 2017 Hypertension Clinical Practice Guidelines4 Recommendation for Screening and Management of CVD Risk (Guideline Section 2.4) 1. 