However, wide individual variability in per- cent LDL-C reduction was noted. Importantly, the magnitude of the percent LDL-C reduction deter- The US Preventive Services Task Force systematic review of statin therapy in primary prevention showed a reduced risk of all-cause and cardiovascular death and ASCVD events and noted greater absolute benefits in those at greater baseline risk,S4.4.2-4 consistent with other high-quality systematic reviews and This underscores the need for aggressive and safe risk reduction in the highest-risk groups and the need for follow- up LDL-C testing to determine adherence and adequacy of effect of the prescribed statin.S4.4.2-26 3. In individuals 40 to 75 years of age, 10-year ASCVD risk assessment begins the clinician patient risk Primary Prevention Recommendations for Adults 40 to 75 Years of Age With LDL Levels 70 to 189 mg/dL (1.7 to 4.8 mmol/L) (Continued) COR LOE Recommendations CLINICAL STATEMENTS AND GUIDELINES Required information includes age, sex, and race/ethnicity; presence of diabetes mellitus or cigarette smoking and treated hypertension; and a current blood pressure level and fasting or nonfasting TC and HDL-C levels. The PCE include a stroke endpoint and race- specific coefficients. This identifies, for example, a black woman who with similar risk factors is at much higher risk than her white counterpart. The PCE were externally validated in a high-qual- ity natural history study published shortly after the 2013 ACC/AHA cholesterol guidelines were These equations may underesti- mate risk in individuals of South Asian ancestry and other high-risk groups and may overestimate risk in selected lower-risk groups.S4.4.2-10 Unlike other risk estimators, the PCE use only fatal and nonfatal stroke and CHD as endpoints. Other risk estimators that include revascularization and additional cardiovascular endpoints provide risk estimates that cannot be compared directly with those given by the PCE. 