For primary prevention, we recommend offering a moderate- dose statin in patients with a >12% 10-year cardiovascular risk or low-density lipoprotein cholesterol >190 mg/dL or diabetes. Strong for Reviewed, New- replaced 7. For primary prevention, we suggest offering a moderate-dose statin for patients with a 10-year cardiovascular risk between 6% and 12% following a discussion of risks, limited benefit, and an exploration of the patient s values and preferences. Weak for Reviewed, New- replaced 8. For primary prevention in patients on moderate-dose statins, we suggest against maximizing the statin dose due to the lack of evidence proving added cardiovascular benefits and the risks of higher dose statins. Weak against Reviewed, New- replaced 9. For primary prevention, there is insufficient evidence to recommend for or against using ezetimibe with or without statins. Neither for nor against Reviewed, New- replaced 10. For primary prevention, we recommend against offering PCSK9 inhibitors due to unknown long-term safety, inconclusive evidence for benefit, and high cost. Strong against Reviewed, New- added b. Secondary Prevention 11. For secondary prevention, we recommend using at least a moderate-dose statin.* Strong for Reviewed, New- replaced 12. For secondary prevention in higher risk patients** who are willing to intensify treatment, we suggest offering high-dose statins for reducing non-fatal cardiovascular events after discussion of the risk of high-dose statins and an exploration of the patient s values and preferences. Weak for Reviewed, New- replaced Topic Sub- topic # Recommendation Strengtha Categoryb Pharmacotherapy, Supplements, and Nutraceuticals (cont.) b. Secondary Prevention (cont.) 13. For secondary prevention in higher risk patients** who are willing to intensify treatment, we suggest adding ezetimibe to either moderate- or high-dose statins for reducing non-fatal cardiovascular events following a discussion of the risks, additional benefits, and an exploration of the patient s values and preferences. 