The backbone of risk reduction involves a concerted effort to affect lifestyle choices. We recognize that there is controversy when it comes to the use of treatment targets. The primary panel continues to believe that monitoring and surveillance of LDL-C levels to achieve consistent target levels or > 50% reduction from baseline will have beneficial effects on outcomes, particularly for high-risk secondary prevention patients. We recognize that several groups have not recommended targets. The optimal approach is certainly in flux and will evolve further as ongoing phase III clinical trials of lipid-lowering therapy will provide further CV outcome evidence about combination therapy in the next 2-3 years. The determination of adherence is not easy without follow-up measurements and variability of response to any selected pharmacologic intervention is also incontrovertible. Regardless of whether one adopts the use of targets with close monitoring, our primary goal is to increase appropriate screening, and emphasize more widespread risk assessment so as promote shared decision-making to use proven effective therapy to reduce the risk to our population.