The focus is on medical practice in the United States, but CPGs developed in collaboration with other organizations may have a broader target.Although CPGs may be used to inform regula- tory or payer decisions, the intent is to improve the quality of care and be aligned with the patient s best interest. Evidence Review Guideline writing committee (GWC) members are charged with reviewing the literature; weighing the strength and quality of evidence for or against particular tests, treatments, or procedures; and estimating expected health outcomes when data exist. In analyzing the data and develop- ing CPGs, the GWC uses evidence-based methodologies devel- oped by the Task Force.6 A key component of the ACC/AHA CPG methodology is the development of recommendations on the basis of all available evidence. Literature searches focus on randomized controlled trials (RCTs) but also include regis- tries, nonrandomized comparative and descriptive studies, case series, cohort studies, systematic reviews, and expert opinion. Only selected references are cited in the CPG. To ensure that CPGs remain current, new data are reviewed biannually by the GWCs and the Task Force to determine if recommendations should be updated or modified. In general, a target cycle of 5 years is planned for full revisions.1 Guideline-Directed Medical Therapy Recognizing advances in medical therapy across the spectrum of cardiovas- cular diseases, the Task Force designated the term guideline- directed medical therapy (GDMT) to represent recommended medical therapy as defined mainly by Class I measures, gen- erally a combination of lifestyle modification and drug- and device-based therapeutics. As medical science advances, GDMT evolves, and hence GDMT is preferred to optimal medical therapy. For GDMT and all other recommended drug treatment regimens, the reader should confirm the dosage with product insert material and carefully evaluate for contraindi- cations and possible drug interactions. 