The Pooled Cohort Equations should be used to estimate the 10-year ASCVD risk in persons without clinical ASCVD to guide initiation of statin therapy. In persons 40 to 75 years of age without clinical ASCVD or diabetes and with an estimated 10-year ASCVD risk of 7.5% or greater, moderate- to high-intensity statin therapy should be used. If the 10-year risk of ASCVD is 5% to less than 7.5%, treatment with a moderate-intensity statin is reasonable. Before initiating statin therapy, it is reasonable for clinicians and patients to engage in a discussion about the potential for ASCVD risk-reduction benefits, adverse events, drug-drug interactions, and patient preferences. Persons with LDL-C less than 190 mg per dL who do not fall into a statin benefit group or for whom risk-based treatment is uncertain, other factors may be used to inform treatment decision making. Statin therapy may be considered after evaluating for potential benefits, adverse events, drug-drug interactions, and patient preferences.