Intended Use Practice guidelines provide recommendations applicable to patients with or at risk of developing CVD. The focus is on medical practice in the United States, but guidelines devel- oped in collaboration with other organizations can have a global impact. Although guidelines may be used to inform regulatory or payer decisions, they are intended to improve patients quality of care and align with patients interests. Guidelines are intended to define practices meeting the needs of patients in most, but not all, circumstances and should not replace clinical judgment. Clinical Implementation Management in accordance with guideline recommendations is effective only when followed by both practitioners and patients. Adherence to recommendations can be enhanced by shared decision making between clinicians and patients, with patient engagement in selecting interventions on the basis of individual values, preferences, and associated conditions and comorbidities. Methodology and Modernization The ACC/AHA Task Force on Clinical Practice Guidelines (Task Force) continuously reviews, updates, and modifies guideline methodology on the basis of published standards from organizations, including the Institute of Medicine,P-3,P-4 and on the basis of internal reevaluation. Similarly, the pre- sentation and delivery of guidelines are reevaluated and modi- fied on the basis of evolving technologies and other factors to facilitate optimal dissemination of information to healthcare professionals at the point of care. Toward this goal, this guideline continues the introduction of an evolved format of presenting guideline recommenda- tions and associated text called the modular knowledge chunk format. Each modular chunk includes a table of related recommendations, a brief synopsis, recommendation-spe- cific supportive text, and when appropriate, flow diagrams or additional tables. References are provided within the modular chunk itself to facilitate quick review. 