Assessment of Cardiovascular Risk e569 3. Lifestyle Factors Affecting Cardiovascular Risk e570 3.1. Nutrition and Diet e570 3.2. Exercise and Physical Activity e570 4. Other Factors Affecting Cardiovascular Risk e570 4.1. Adults With Overweight and Obesity e570 4.2. Adults With Type 2 Diabetes Mellitus e570 4.3. Adults With High Blood Cholesterol e571 4.4. Adults With High Blood Pressure or Hypertension e573 4.5. Treatment of Tobacco Use e574 4.6. Aspirin Use e575 5. Cost and Value Considerations e575 6. Conclusion e576 References e578 Appendix 1: Search Criteria e585 Appendix 2: Author Relationships With Industry and Other Entities (Relevant) e589 Appendix 3 Reviewer Relationships With Industry and Other Entities (Comprehensive) e591 TOP 10 TAKE-HOME MESSAGES FOR THE PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE 1. The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life. 2. A team-based care approach is an effective strat- egy for the prevention of cardiovascular disease. Clinicians should evaluate the social determinants of health that affect individuals to inform treat- ment decisions. 3. Adults who are 40 to 75 years of age and are being evaluated for cardiovascular disease prevention should undergo 10-year atherosclerotic cardiovas- cular disease (ASCVD) risk estimation and have a clinician patient risk discussion before starting on pharmacological therapy, such as antihyperten- sive therapy, a statin, or aspirin. The presence or absence of additional risk-enhancing factors can help guide decisions about preventive interven- tions in select individuals, as can coronary artery calcium scanning. 4. All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, red meat and processed red meats, refined carbohy- drates, and sweetened beverages. 