Primary prevention, no statin: Lipids every 10 years, recommend non-fasting; Repeat risk evaluation at If risk factors change. 2. Secondary prevention: lipids as needed only if higher risk and willing to intensify; 3. Once on optimal therapy, no need to recheck lipids routinely 3. Box 7 connects to Box 11, in the shape of a rectangle: Recommend dietitian-led Mediterranean diet for risk >12% 4. Box 11 connects to Box 12, in the shape of a rectangle: Recommend regular aerobic exercise (Suggest regular aerobic activity of any intensity or duration. Although incremental benefit is associated with increased doses of physical activity, lower doses including leisure time activity [i.e., walking, landscaping, washing dishes] are associated with benefit when compared to mostly sedentary behavior. A provider s considerations when recommending physical activity might include a patient s motivation, functional capacity, and physical activity preferences.) and smoking cessation (if applicable) 5. Box 12 connects to Box 13, in the shape of a rectangle: Follow up evaluation: 1. Primary prevention, no statin: Lipids every 10 years, recommend non-fasting; Repeat risk evaluation at Box 1: Every 2 years if 6 12%, Every 5 years if <6%, If risk factors change. 2. Secondary prevention: lipids as needed only if higher risk and willing to intensify; 3. Once on optimal therapy, no need to recheck lipids routinely References 1. U.S. Department of Veterans Affairs/Department of Defense Health Executive Committee (HEC). Evidence based practice work group charter. January 9, 2017. 2. U.S. Centers for Disease Control and Prevention. Total and high-density lipoprotein cholesterol in adults: United States, 2015 2016. 2017. www.cdc.gov/nchs/products/databriefs/db290.htm. Accessed Nov 1, 2019. 3. Virani SS, Alonso A, Benjamin EJ, et al. Heart disease and stroke statistics-2020 update: A report from the American Heart Association. Circulation. Mar 3 2020;141(9):e139-e596. PMID: 31992061. 4. 