Thus, after calculation of the PCE, it is reasonable to use additional risk-enhancing factors to guide decisions about preventive interventions for bor- derline- or intermediate-risk adults.S2.2-4 S2.2-14 However, the value of preventive therapy may remain uncertain for many individuals with borderline or intermediate es- timated 10-year risk, and some patients may be reluc- tant to take medical therapy without clearer evidence of increased ASCVD risk. For these individuals, the as- sessment of coronary artery calcium is a reasonable tool to reclassify risk either upward or downward, as part of shared decision-making. For younger adults 20 to 59 years of age, estimation of lifetime risk may be considered. For adults >75 years of age, the clinician and patient should engage in a discussion about the possible benefits of preventive therapies appropriate to the age group in the context of comorbidities and life expectancy. Recommendation-Specific Supportive Text 1. To facilitate decisions about preventive interven- tions, it is recommended to screen for traditional ASCVD risk factors and apply the race- and sex- specific PCE (ASCVD Risk Estimator) to estimate 10-year ASCVD risk for asymptomatic adults 40 to For management of stage 1 hypertension (BP 130 139 / 80 89 mm Hg), adults should be categorized as <10% or >10% 10-year ASCVD risk for therapeutic decisions (see Section 4.4 Figure 4). For management of blood cholesterol, adults should be categorized as having The PCE are best validated among non- Hispanic whites and non-Hispanic blacks living in the United States.S2.2-1,S2.2-39,S2.2-48,S2.2-49,S2.2-52 In other or in some non- the PCE may overestimate or underestimate risk. Therefore, clinicians may consider the use of another risk prediction tool as an alternative to the PCE if the tool was validated in a population with charac- teristics similar to those of the evaluated patient. 