Lifestyle Therapies and Metabolic Syndrome e1090 3.2. Lipid-Lowering Drugs e1090 3.2.1. Statin Therapy e1090 3.2.2. Nonstatin Therapies e1091 3.2.3. Nonstatin Add-on Drugs to Statin Therapy e1091 4. Patient Management Groups e1091 4.1. Secondary ASCVD Prevention e1091 4.2. Severe Hypercholesterolemia (LDL-C 190 mg/dL [ 4.9 mmol/L]) e1095 4.3. Diabetes Mellitus in Adults e1097 4.4. Primary Prevention e1099 4.4.1. Evaluation and Risk Assessment e1099 4.4.2. Primary Prevention Adults 40 to 75 Years of Age With LDL-C Levels 4.4.3. Monitoring in Response to LDL-C Lowering Therapy e1106 4.4.4. Primary Prevention in Other Age Groups e1107 4.5. Other Populations at Risk e1111 4.5.1. Ethnicity e1111 4.5.2. Hypertriglyceridemia e1112 5. Statin Safety and Statin-Associated Side Effects e1117 6. Implementation e1120 7. Cost and Value Considerations e1121 7.1. Economic Value Considerations: PCSK9 Inhibitors e1121 8. Limitations and Knowledge Gaps e1122 8.1. Randomized Controlled Trials e1122 8.2. Risk Assessment e1122 8.2.1. Continuing Refinement of PCE e1123 8.2.2. Improvement in Lifetime Risk Estimate e1123 8.2.3. Refinement of Clinician Patient Risk Discussion e1123 8.2.4. Monitoring and Adjustment of Treatment e1123 8.2.5. Prognostic Significance of CAC e1123 References e1124 Appendix 1: Author Relationships With Industry and Other Entities (Relevant) 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol Appendix 2: Reviewer Relationships With Industry and Other Entities (Comprehensive) 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/ AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol TOP 10 TAKE-HOME MESSAGES TO REDUCE RISK OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE THROUGH CHOLESTEROL MANAGEMENT 1. In all individuals, emphasize a heart-healthy lifestyle across the life course. A healthy lifestyle reduces atherosclerotic cardiovascular disease (ASCVD) risk at all ages. In younger indi- viduals, healthy lifestyle can reduce development of risk factors and is the foundation of ASCVD risk reduction. In young adults 20 to 39 years of age, an assessment of lifetime risk facilitates the clinician patient risk discussion (see No. 