This new term, GDMT, will be used herein and throughout all future guidelines. Because the ACCF/AHA practice guidelines address patient populations (and clinicians) residing in North Amer- ica, drugs that are not currently available in North America are discussed in the text without a speci c COR. For studies performed in large numbers of subjects outside North America, each writing committee reviews the potential in uence of different practice patterns and patient populations on the treatment effect and relevance to the ACCF/AHA target population to determine whether the ndings should inform a speci c recommendation. The ACCF/AHA practice guidelines are intended to assist clinicians in clinical decision making by describing a range of generally acceptable approaches to the diagnosis, management, and prevention of speci c diseases or condi- tions. The guidelines attempt to de ne practices that meet the needs of most patients in most circumstances. The ultimate judgment regarding care of a particular patient must be made by the clinician and patient in light of all the circumstances presented by that patient. As a result, situa- tions may arise for which deviations from these guidelines may be appropriate. Clinical decision making should involve consideration of the quality and availability of expertise in the area where care is provided. When these guidelines are used as the basis for regulatory or payer decisions, the goal should be improvement in quality of care. The Task Force recognizes that situations arise in which additional data are needed to inform patient care more effectively; these areas will be identi ed within each respective guideline when appropriate. Prescribed courses of treatment in accordance with these recommendations are effective only if followed. Because lack JACC Vol. 62, No. 16, 2013 Yancy et al. 