In the absence of new CV risk factor development, it is reasonable to perform a CV risk assessment every five years. For patients whose 10-year CV risk score is 6 12%, it is reasonable to repeat CV risk assessment at earlier time intervals to capture patients who may benefit from the initiation of appropriate statin therapy as a change in age alone may alter CV risk score, thus enhancing the provider-patient CVD primary prevention discussion. This CPG s systematic evidence review identified two prospective cohort studies evaluating the timing of repeat screening for CV risk in primary prevention populations based on prediction of CV events or reclassification of CV risk.[20,21] Chamnan et al. (2016) evaluated 12,197 patients for CVD event rates utilizing the Framingham Risk Score (FRS). Prediction of CVD events based on the FRS did not change significantly between the baseline and second visit (mean: 3.7 years).[20] Angelow et al. (2015) evaluated 1,112 patients by estimating CVD risk utilizing the Systematic Coronary Risk Evaluation (SCORE)-Germany prediction model inputting both a 5- or 10-year old total cholesterol (TC) to predict high CV risk. [21] The authors observed only minor changes in TC over time. Moreover, they reported that utilizing 5- or 10-year old TC levels had high sensitivity and specificity to identify patients at high CV risk and resulted in low misclassification rates. The authors concluded that measuring TC at five-year intervals is sufficiently accurate for primary CVD prevention.[21] Cardiovascular disease risk assessment models provide a foundation for shared decision making to review the anticipated benefit of preventative interventions while minimizing the potential harm from overtreatment. As CV risk scoring influences treatment decisions and frequently involves laboratory testing, excessive monitoring may lead to unnecessary testing and/or treatments. 