1. High-risk defined as: clinical atherosclerosis, abdominal aortic aneurysm, or an adjusted FRS of ≥20% (Recommendation Strong, Quality High).
2. Definition also includes:
   • Diabetes >15 years duration and age ≥30 years, diabetes with age ≥40 years, or the presence of microvascular disease (not all subjects with diabetes are at high 10-year risk; included for treatment based on randomized studies and high long-term risk.)
   • High-risk kidney disease (GFR ≤45 mL/min/1.73 m² or ACR ≥30 mg/mmol or GFR ≤60 mL/min/1.73 m² and ACR ≥3 mg/mmol;)
   • High-risk hypertension (hypertension plus three of the following risk factors: male, age >55 years, smoking, total cholesterol/HDL-C ratio >6, left ventricular hypertrophy, family history of premature CVD, electrocardiogram abnormalities, or microalbuminuria)
   (Recommendation Strong, Quality Moderate)
3. Target LCL-C ≤2.0 mmol/L or ≥50% reduction of LDL-C for high-risk individuals in whom treatment is initiated (Recommendation Strong, Quality Moderate)
4. Apo B ≤0.80 g/L or non-HDL-C ≤2.6 mmol/L may be considered as alternative treatment targets for optimal risk reduction (Recommendation Strong, Quality Moderate).

Values and Preferences

• Addition of chronic kidney disease to high-risk category was based on significant emerging epidemiologic data and recently published SHARP data
• Treatment of dyslipidemia in subjects on hemodialysis remains controversial and individual judgment is required