J A C C V O L . 6 7 , N O . 1 0 , 2 0 1 6 of Cardiology (ACC)/American Heart Association (AHA) Task Force on Clinical Practice Guidelines ( Task Force ) has issued this focused update to revise guideline rec- ommendations on the basis of recently published data. This update is not based on a complete literature review from the date of previous guideline publications, but it has been subject to rigorous, multilevel review and approval, similar to the full guidelines. For speci c focused update criteria and additional methodological details, please see the ACC/AHA guideline methodology manual (1). Modernization In response to published reports from the Institute of Medicine (2,3) and ACC/AHA mandates (4 7), processes have changed leading to adoption of a knowledge byte format. This entails delineation of recommendations addressing speci c clinical questions, followed by concise text, with hyperlinks to supportive evidence. This approach better accommodates time constraints on busy clinicians, facilitates easier access to recommendations via electronic search engines and other evolving tech- nology (e.g., smart phone apps), and supports the evolu- tion of guidelines as living documents that can be dynamically updated as needed. Intended Use Practice guidelines provide recommendations applicable to patients with or at risk of developing cardiovascular disease. The focus is on medical practice in the United States, but guidelines developed in collaboration with other organiza- tions may have a broader target. Although guidelines may inform regulatory or payer decisions, they are intended to improve quality of care in the interest of patients. Class of Recommendation and Level of Evidence The Class of Recommendation (COR) and Level of Evi- dence (LOE) are derived independently of one another according to established criteria. 