This risk group benefits greatly from a clini- cian patient risk discussion. To arrive at a shared risk decision, clinicians should assess the patient s priorities for health care, perceived ASCVD risk, and prior risk-reduction experiences and should use best practices to communicate numerical The presence of risk-enhancing fac- tors provides useful information about short term ASCVD risk favoring initiation of statin therapy Although a CAC score can be use- ful in selected individuals, it will be positive less often in this lower-risk group than in those with higher levels of ASCVD risk and is not recom- 4.4.3. Monitoring in Response to LDL-C Lowering Therapy Recommendation for Monitoring Referenced studies that support the recommendation are summarized in Online Data Supplement 17. COR LOE Recommendation I A Adherence to changes in lifestyle and effects of LDL-C lowering medication should be assessed by measurement of fasting lipids and appropriate safety indicators 4 to 12 weeks after statin initiation or dose adjustment and every 3 to 12 months thereafter based on need to assess adherence or safety.S4.4.3-1 S4.4.3-3 Recommendation-Specific Supportive Text 1. Goals for LDL-C lowering in response to life- style therapies or a prescribed intensity of statin therapy are defined by percentage responses. Clinical efficacy is monitored by measurement of percentage reductions in LDL-C relative to base- line levels. Baseline LDL-C can be estimated by pretreatment measurements, chart reviews, or measurement after a short interruption of drug therapy. Some clinicians are reluctant to interrupt therapy, although risk is low. Unless a baseline level is established, it will be difficult to evaluate response to therapy. Good adherence to various LDL-lowering diets will reduce LDL-C levels by Moderate-intensity statins can be expected to reduce LDL-C levels by another 30% to 49%, and high-intensity statins by 50% CLINICAL STATEMENTS AND GUIDELINES (Table 3, Section 3.2.). 