If statins are indicated, reduce LDL-C levels by 30%, and if 10-year risk is 20%, reduce LDL-C levels by 50%. 8. In adults 40 to 75 years of age without dia- betes mellitus and 10-year risk of 7.5% to 19.9% (intermediate risk), risk-enhancing factors favor initiation of statin therapy (see No. 7). Risk-enhancing factors include family history of premature ASCVD; persistently ele- vated LDL-C levels 160 mg/dL ( 4.1 mmol/L); metabolic syndrome; chronic kidney disease; his- tory of preeclampsia or premature menopause (age <40 years); chronic inflammatory disorders (eg, rheumatoid arthritis, psoriasis, or chronic HIV); high-risk ethnic groups (eg, South Asian); persistent elevations of triglycerides 175 mg/dL ( 1.97 mmol/L); and, if measured in selected indi- viduals, apolipoprotein B 130 mg/dL, high-sensi- tivity C-reactive protein 2.0 mg/L, ankle-brachial index <0.9 and lipoprotein (a) 50 mg/dL or 125 nmol/L, especially at higher values of lipoprotein (a). Risk-enhancing factors may favor statin ther- apy in patients at 10-year risk of 5-7.5% (border- line risk). 9. In adults 40 to 75 years of age without diabe- tes mellitus and with LDL-C levels 70 mg/dL to 189 mg/dL ( 1.8-4.9 mmol/L), at a 10-year ASCVD risk of 7.5% to 19.9%, if a decision about statin therapy is uncertain, consider measuring CAC. If CAC is zero, treatment with statin therapy may be withheld or delayed, except in cigarette smokers, those with diabetes mellitus, and those with a strong family history of prema- ture ASCVD. A CAC score of 1 to 99 favors statin therapy, especially in those 55 years of age. For any patient, if the CAC score is 100 Agatston units or 75th percentile, statin therapy is indi- cated unless otherwise deferred by the outcome of clinician patient risk discussion. 10. 