The American Heart Association requests that this document be cited as follows: Arnett DK,
Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Himmelfarb CD, Khera A,
Lloyd-Jones D, McEvoy JW, Michos ED, Miedema MD, Muñoz D, Smith SC Jr, Virani SS,
Williams KA Sr, Yeboah J, Ziaeian B. 2019 ACC/AHA guideline on the primary prevention of
cardiovascular disease: executive summary: a report of the American College of
Cardiology/American Heart Association Task Force on Clinical Practice Guidelines …

Although there has been substantial improvement in atherosclerotic cardiovascular disease
(ASCVD) outcomes in recent decades, ASCVD remains the leading cause of morbidity and
mortality globally (S1-1–S1-3). In the United States, it is also the leading cause of death for
people of most racial/ethnic groups, with an estimated cost of> $200 billion annually in
healthcare services, medications, and lost productivity. Much of this is attributable to
suboptimal implementation of prevention strategies and uncontrolled ASCVD risk factors in …