Strong for Reviewed, New- added a For additional information, see Grading Recommendations. b For additional information, see Recommendation Categorization and Appendix G. * Statin doses listed as moderate are equivalent to moderate intensity; statin doses listed as high are equivalent to high intensity ** Higher risk patients include those with (1) MI or ACS in past 12 months; (2) recurrent ACS, MI, or CVA; or (3) established CVD and with additional risk factors (e.g., currently smoking, DM, PAD, or CABG/PCI). A. Screening and Assessment of Cardiovascular Risk Recommendation 1. For primary prevention in patients over age 40 and not on statin therapy who have not developed new cardiovascular risk factors (e.g., diabetes, hypertension, tobacco use), we suggest against offering a cardiovascular disease risk assessment more frequently than every five years. (Weak against | Reviewed, Amended) Discussion Cardiovascular risk assessment models are widely used in clinical practice as a strategy for identifying patients who are most likely to benefit from treatment for the primary prevention of CVD. Risk equation models incorporate both modifiable and non-modifiable risk factors including age, gender, ethnicity, blood pressure, tobacco use, cholesterol levels, and diabetes mellitus (DM) to calculate 10-year and lifetime CVD risk. For primary prevention of CVD in low-risk patients not on statin therapy, frequent cholesterol screening or CV risk assessment is unlikely to reclassify 10-year risk or influence clinical management. In the absence of new CV risk factor development, it is reasonable to perform a CV risk assessment every five years. 