Effect of blood pres- sure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. 2002;288:2421 31. CLINICAL STATEMENTS AND GUIDELINES S4.4-45. Upadhyay A, Earley A, Haynes SM, et al. Systematic review: blood pressure target in chronic kidney disease and proteinuria as an effect modifier. Ann Intern Med. 2011;154:541 8. S4.4-46. Jafar TH, Stark PC, Schmid CH, et al. Progression of chronic kidney disease: the role of blood pressure control, proteinuria, and angio- tensin-converting enzyme inhibition: a patient-level meta-analysis. Ann Intern Med. 2003;139:244 52. S4.4-47. Lv J, Ehteshami P, Sarnak MJ, et al. Effects of intensive blood pressure lowering on the progression of chronic kidney disease: a systematic review and meta-analysis. CMAJ. 2013;185:949 57. S4.4-48. Klahr S, Levey AS, Beck GJ, et al. The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. Modification of Diet in Renal Disease Study Group. N Engl J Med. 1994;330:877 84. S4.4-49. Emdin CA, Rahimi K, Neal B, et al. Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2015;313:603 15. S4.4-50. Arguedas JA, Leiva V, Wright JM. Blood pressure targets for hyper- tension in people with diabetes mellitus. Cochrane Database Syst Rev. 2013:CD008277. S4.4-51. Margolis KL, O Connor PJ, Morgan TM, et al. Outcomes of com- bined cardiovascular risk factor management strategies in type 2 diabetes: the ACCORD randomized trial. Diabetes Care. 2014;37: 1721 8. S4.4-52. Bress AP, Bellows BK, King JB, et al. Cost-effectiveness of inten- sive versus standard blood-pressure control. N Engl J Med. 2017;377:745 55. S4.4-53. Soliman EZ, Byington RP, Bigger JT, et al. Effect of intensive blood pressure lowering on left ventricular hypertrophy in patients with diabetes mellitus: Action to Control Cardiovascular Risk in Diabetes blood pressure trial. Hypertension. 2015;66:1123 9. S4.4-54. ACCORD Study Group Cushman WC, Evans GW, et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362:1575 85. S4.4-55. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of indi- vidual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903 13. S4.4-56. Kassa B, Boissel J-P, Cucherat M, et al. Treatment of high blood pres- sure and gain in event-free life expectancy. Vasc Health Risk Manag. 2005;1:163 9. S4.4-57. van Dieren S, Kengne AP, Chalmers J, et al. Effects of blood pressure lowering on cardiovascular outcomes in different cardiovascular risk groups among participants with type 2 diabetes. Diabetes Res Clin Pract. 2012;98:83 90. S4.4-58. Montgomery AA, Fahey T, Ben-Shlomo Y, et al. The influence of absolute cardiovascular risk, patient utilities, and costs on the deci- sion to treat hypertension: a Markov decision analysis. J Hypertens. 2003;21:1753 9. S4.4-59. Lonn EM, Bosch J, L pez-Jaramillo P, et al. Blood-pressure lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med. 2016;374:2009 20. S4.4-60. Neaton JD, Grimm RH Jr, Prineas RJ, et al. Treatment of Mild Hypertension Study. Final results. Treatment of Mild Hypertension Study Research Group. JAMA. 1993;270:713 24. S4.4-61. Julius S, Nesbitt SD, Egan BM, et al. Feasibility of treating prehy- pertension with an angiotensin-receptor blocker. N Engl J Med. 2006;354:1685 97. S4.4-62. Lawes CMM, Bennett DA, Lewington S, et al. Blood pressure and coronary heart disease: a review of the evidence. Semin Vasc Med. 2002;2:355 68. S4.4-63. Inder JD, Carlson DJ, Dieberg G, et al. Isometric exercise training for blood pressure management: a systematic review and meta-analysis to optimize benefit. Hypertens Res. 2016;39:88 94. S4.4-64. National Institute on Alcohol Abuse and Alcoholism. What Is A Standard Drink? Available at: https://www.niaaa.nih.gov/alco- hol-health/overview-alcohol-consumption/what-standard-drink. Accessed August 16, 2017. S4.4-65. National Heart, Lung, and Blood Institute. Your Guide to Lowering Your Blood Pressure With DASH How Do I Make the DASH? Available at: https://health.gov/dietaryguidelines/dga2005/toolkit/ DASH/how_make_dash.htm. Accessed January 6, 2019. S4.4-66. Top 10 Dash Diet Tips. Available at: http://dashdiet.org/dash-diet- tips.html. Accessed January 6, 2019. 4.5. Tobacco Use S4.5-1. Carson KV, Verbiest MEA, Crone MR, et al. Training health pro- fessionals in smoking cessation. Cochrane Database Syst Rev. 2012:CD000214. S4.5-2. Patnode CD, Henderson JT, Thompson JH, et al. Behavioral coun- seling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the US Preventive Services Task Force. Ann Intern Med. 2015;163:608 21. S4.5-3. Stead LF, Koilpillai P, Fanshawe TR1, et al. Combined pharmacother- apy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev. 2016;3:CD008286. S4.5-4. Pan A, Wang Y, Talaei M, et al. Relation of smoking with total mortality and cardiovascular events among patients with diabe- tes mellitus: a meta-analysis and systematic review. Circulation. 2015;132:1795 804. S4.5-5. Mons U, M ezzinler A, Gellert C, et al. Impact of smoking and smok- ing cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium. BMJ. 2015;350:h1551. S4.5-6. Lv X, Sun J, Bi Y, et al. Risk of all-cause mortality and cardiovascular disease associated with secondhand smoke exposure: a systematic review and meta-analysis. Int J Cardiol. 2015;199:106 15. S4.5-7. Barua RS, Rigotti NA, Benowitz NL, et al. 2018 ACC Expert Consensus Decision Pathway on Tobacco Cessation Treatment: A Report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2018;72:3332 65. S4.5-8. Anthenelli RM, Benowitz NL, West R, et al. Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial. Lancet. 2016;387:2507 20. S4.5-9. Prochaska JJ, Benowitz NL. The past, present, and future of nicotine addiction therapy. Annu Rev Med. 2016;67:467 86. 4.6. Aspirin Use S4.6-1. Guirguis-Blake JM, Evans CV, Senger CA, et al. Aspirin for the pri- mary prevention of cardiovascular events: a systematic evidence review for the US Preventive Services Task Force. Ann Intern Med. 2016;164:804 13. S4.6-2. Whitlock EP, Burda BU, Williams SB, et al. Bleeding risks with aspirin use for primary prevention in adults: a systematic review for the US Preventive Services Task Force. Ann Intern Med. 2016;164:826 35. S4.6-3. Lotrionte M, Biasucci LM, Peruzzi M, et al. Which aspirin dose and preparation is best for the long-term prevention of cardiovascular disease and cancer? Evidence from a systematic review and network meta-analysis. Prog Cardiovasc Dis. 2016;58:495 504. S4.6-4. Raju N, Sobieraj-Teague M, Bosch J, et al. Updated meta-analysis of aspirin in primary prevention of cardiovascular disease. Am J Med. 2016;129:e35 6. S4.6-5. Ogawa H, Nakayama M, Morimoto T, et al. Low-dose aspirin for primary prevention of atherosclerotic events in patients with type 2 diabetes: a randomized controlled trial. JAMA. 2008;300:2134 41. S4.6-6. Belch J, MacCuish A, Campbell I, et al. The prevention of progres- sion of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. BMJ. 2008;337:a1840. S4.6-7. Fowkes FGR, Price JF, Stewart MCW, et al. Aspirin for prevention of cardiovascular events in a general population screened for a low ankle brachial index: a randomized controlled trial. JAMA. 2010;303:841 8. S4.6-8. Ikeda Y, Shimada K, Teramoto T, et al. Low-dose aspirin for primary prevention of cardiovascular events in Japanese patients 60 years or older with atherosclerotic risk factors: a randomized clinical trial. JAMA. 2014;312:2510 20. S4.6-9. McNeil JJ, Wolfe R, Woods RL, et al. Effect of aspirin on cardio- vascular events and bleeding in the healthy elderly. N Engl J Med. 2018;379:1509 18. S4.6-10. Garc a Rodr guez LA, Mart n-P rez M, Hennekens CH, et al. Bleeding risk with long-term low-dose aspirin: a systematic review of observa- tional studies. PLoS ONE. 2016;11:e0160046. CLINICAL STATEMENTS AND GUIDELINES 5. COST AND VALUE CONSIDERATIONS S5-1. Weintraub WS, Daniels SR, Burke LE, et al. Value of primordial and pri- mary prevention for cardiovascular disease: a policy statement from the American Heart Association. Circulation. 2011;124:967 90. S5-2. Anderson JL, Heidenreich PA, Barnett PG, et al. ACC/AHA state- ment on cost/value methodology in clinical practice guidelines and performance measures: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and Task Force on Practice Guidelines. Circulation. 2014;129:2329 45. S5-3. Bress AP, Bellows BK, King JB, et al. Cost-effectiveness of inten- sive versus standard blood-pressure control. N Engl J Med. 2017;377:745 55. S5-4. Moran AE, Odden MC, Thanataveerat A, et al. Cost-effectiveness of hypertension therapy according to 2014 guidelines. N Engl J Med. 2015;372:447 55. S5-5. Park C, Wang G, Durthaler JM, et al. Cost-effectiveness analyses of antihypertensive medicines: a systematic review. Am J Prev Med. 2017;53:S131 42. S5-6. Richman IB, Fairley M, J rgensen ME, et al. Cost-effectiveness of intensive blood pressure management. JAMA Cardiol. 2016;1:872 9. S5-7. Heller DJ, Coxson PG, Penko J, et al. Evaluating the impact and cost- effectiveness of statin use guidelines for primary prevention of coro- nary heart disease and stroke. Circulation. 2017;136:1087 98. S5-8. Odden MC, Pletcher MJ, Coxson PG, et al. Cost-effectiveness and population impact of statins for primary prevention in adults aged 75 years or older in the United States. Ann Intern Med. 2015;162:533 41. S5-9. Heart Protection Study Collaborative Group. Statin cost-effective- ness in the United States for people at different vascular risk levels. Circ Cardiovasc Qual Outcomes. 2009;2:65 72. S6-1. Lehr AL, Driver SL, Stone NJ. The ABCDs of lifestyle counseling. JAMA Cardiol. 2016;1:505 6. APPENDIX 1. SEARCH CRITERIA 1. Patnode CD, Evans CV, Senger CA, et al. Behavioral counseling to pro- mote a healthful diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2017;318:175 93. 2. LeBlanc ES, Patnode CD, Webber EM, et al. Behavioral and pharmaco- therapy weight loss interventions to prevent obesity-related morbidity and mortality in adults: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2018;320:1172 91. 3. Selph S, Dana T, Bougatsos C, et al. Screening for abnormal glucose and type 2 diabetes mellitus: a systematic review to update the 2008 US Preventive Services Task Force Recommendation. Report No. 13-05190- EF-1. 2015, US Agency for Healthcare Research and Quality:Rockville, MD. Available at: http://www.ncbi.nlm.nih.gov/books/NBK293871. Accessed January 5, 2019. 4. Patnode CD, Henderson JT, Thompson JH, et al. Behavioral counsel- ing and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the US Preventive Services Task Force. Ann Intern Med. 2015;163:608 21. 5. Guirguis-Blake JM, Evans CV, Senger CA, et al. Aspirin for the pri- mary prevention of cardiovascular events: a systematic evidence review for the US Preventive Services Task Force. Ann Intern Med. 2016;164:804 13. CLINICAL STATEMENTS AND GUIDELINES APPENDIX 1. SEARCH CRITERIA The rapid review conducted by the Evidence-based Practice Center to complete this literature search, in the limited timeframe provided, built on existing systematic reviews conducted on behalf of the USPSTF. Medical Subject Headings (MeSH) Terms Key Words Nutrition and Diet Search since the 2017 review1 exp Diet/ diet* exp Diet Therapy/ cardiovascular Healthy Diet coronary Primary Prevention/ heart myocardial infarction MI CVD CHD cerebrovascular stroke microvascular mortality prevent* Obesity and Weight Loss Search since the 2018 review2 exp Obesity/ obes* exp Weight Loss overweight Primary Prevention/ weight cardiovascular coronary heart myocardial infarction MI CVD CHD cerebrovascular stroke microvascular mortality prevent* Type 2 Diabetes Mellitus Search since the 2015 review3 exp Diabetes Mellitus, Type 2/ impaired fasting glucose Prediabetic State/ impaired glucose tolerance Glucose Intolerance/ Ifg Primary Prevention/ Igt prediabetes* type 2 diabet* DM cardiovascular coronary heart myocardial infarction MI CVD CHD cerebrovascular stroke microvascular mortality prevent* Tobacco Use Search since the 2015 review4 Smoking/ smoking exp "Tobacco Use Cessation"/ cigarette* "Tobacco Use Disorder"/ tobacco Electronic Cigarettes/ nicotine Primary Prevention/ vape vaping e-cigarette electronic cigarette electronic nicotine delivery system* ENDS cardiovascular coronary heart myocardial infarction MI CVD CHD cerebrovascular stroke microvascular mortality prevent* Aspirin Use Search since the 2016 review5 Aspirin aspirin exp Cerebrovascular Disorders/ acetylsalicylic acid exp Cardiovascular Diseases/ clopidogrel Primary Prevention/ cardiovascular coronary heart myocardial infarction Appendix 1. Continued Medical Subject Headings (MeSH) Terms Key Words (Continued) (Continued) CLINICAL STATEMENTS AND GUIDELINES Primary Prevention/ MI CVD CHD cerebrovascular stroke microvascular mortality prevent* Social Determinants of Health Search limited to English. No date restrictions (conducted 7/11/2018) Similar articles searches were also conducted where potentially highly relevant papers were found NONE SPECIFIED, BUT DUE TO AUTOMATIC TERM MAPPING IN PUBMED, SOME MeSH TERMS MAY HAVE BEEN EMPLOYED Social determinants of health Equity Social status Social deprivation Neighborhood Neighborhood conditions Uninsured Housing Immigration Adverse childhood events Social gradient Educational status Inequalities Sexuality Atherosclerosis cardiovascular Team Based Care Search limited to English, 1/1/2010-10/14/2018 (though earlier articles may have been identified through related articles search) Related articles searches were also conducted where potentially highly relevant papers were found NONE SPECIFIED, BUT DUE TO AUTOMATIC TERM MAPPING IN PUBMED, SOME MeSH TERMS MAY HAVE BEEN EMPLOYED team Team care Collaborative care Multidisciplinary team based team approach prevention Primary prevention Cardiovascular disease, Cholesterol Aspirin Smoking Obesity Heart disease Atherosclerosis stroke Shared Decision Making Search limited to English, 1/1/2010-10/24/2018 (though earlier articles may have been identified through related articles search) Related articles searches were also conducted where potentially highly relevant papers were found NONE SPECIFIED, BUT DUE TO AUTOMATIC TERM MAPPING IN PUBMED, SOME MeSH TERMS MAY HAVE BEEN AUTOMATICALLY EMPLOYED Shared decision making Prevention Cardiovascular Atherosclerosis Stroke Heart Hypertension Lipids Cholesterol diabetes Exercise & Physical Activity Search limits: Not ACP Journal Club OR Summaries for patients OR Editorial OR case-report OR letter OR letter OR abstract OR newspaper article OR comment OR baseline characteristics OR study design OR methodology Terms to identify clinical trials/SRs/Mas: Filters: Meta-Analysis, Systematic Reviews, Clinical Trial, Controlled Clinical Trial, Randomized Controlled Trial, From 2011/01/01 to 2018/05/25, Humans, English, Adult: 19+ years Terms to identify observational studies: 2011/01/01 to 2018/12/31, Humans, English, Epidemiologic Studies, Case- Control Studies, Cohort Studies, Cross-Sectional Studies, epidemiolog* AND stud*, case control, cohort stud*, cross sectional, cohort analys*, follow up stud*, longitudinal, retrospective, prospective, observational AND stud* Filters: Adult: 19+ years Waist Circumference Search limited to adult populations, 01/01/2010-10/3/18, English language Acute Coronary Syndrome Acute coronary syndromes Angina Unstable Unstable angina?, Angina Unstable Myocardial infarction Myocardial infarctions Shock cardiogenic shock cardiogenic Myocardial Stunning myocardial stunning No Reflow Phenomenon Heart Arrest St elevation myocardial infarction STEMI Non-st elevated myocardial infarction NSTEMI death/sudden cardiac Stroke Brain Infarction Brain Stem Infarctions Lateral Meduallary Syndrome Appendix 1. Continued Medical Subject Headings (MeSH) Terms Key Words Appendix 1. Continued Medical Subject Headings (MeSH) Terms Key Words (Continued) (Continued) CLINICAL STATEMENTS AND GUIDELINES Cerebral Infarction Myocardial ischemia Dementia Multi infarct infarction anterior cerebral artery infarction middle cerebral artery infarction posterior cerebral artery Myocardial revascularization Coronary artery bypass Internal mammary coronary artery anastomosis Angioplasty "angioplasty transluminal percutaneous coronary" Heart failure Hospitalization Hospitalization? OR rehospitalization? atherectomy coronary Coronary stent CABG bypass grafts Carotid pathology physiopathology Non-coronary revascularization procedure Carotid revascularization? Lower extremity revascularization? Percutaneous transluminal angioplast? Stent placement? Abdominal aortic aneurysm repair? AAA repair? complications Event? OR outcome? OR episode? Risk score Coronary risk modification Cardiovascular diseases Cardiovascular OR CVD Cardiovascular disease Coronary disease coronary Coronary artery disease Myocardial infarction Heart failure CHF OR CHD Cerebrovascular disorders dyspnea paroxysmal edema cardiac Physical fitness Motor activity Exercise tolerance Metabolic equivalent Metabolic equivalent Exercise test Graded exercise test OR gxt Life style or lifestyle Exercise Training Walking Maximal met Mets Physical activity Maximal metabolic? Acute Coronary Syndrome Acute coronary syndromes Angina Unstable Unstable angina?, Angina Unstable Myocardial infarction Myocardial infarctions Shock cardiogenic shock cardiogenic Myocardial Stunning myocardial stunning No Reflow Phenomenon Heart Arrest St elevation myocardial infarction STEMI Non-st elevated myocardial infarction NSTEMI death/sudden cardiac Stroke Brain Infarction Brain Stem Infarctions Lateral Meduallary Syndrome Cerebral Infarction Myocardial ischemia Dementia Multi infarct infarction anterior cerebral artery infarction middle cerebral artery infarction posterior cerebral artery Myocardial revascularization Coronary artery bypass Internal mammary coronary artery anastomosis Angioplasty "angioplasty transluminal percutaneous coronary" Heart failure Hospitalization Hospitalization? OR rehospitalization? atherectomy coronary Coronary stent CABG bypass grafts Carotid pathology Appendix 1. Continued Medical Subject Headings (MeSH) Terms Key Words Appendix 1. Continued Medical Subject Headings (MeSH) Terms Key Words (Continued) (Continued) CLINICAL STATEMENTS AND GUIDELINES physiopathology Non-coronary revascularization procedure Carotid revascularization? Lower extremity revascularization? Percutaneous transluminal angioplast? Stent placement? Abdominal aortic aneurysm repair? AAA repair? complications Event? OR outcome? OR episode? Risk score Coronary risk modification Cardiovascular diseases Cardiovascular OR CVD Cardiovascular disease Coronary disease coronary Coronary artery disease Myocardial infarction Heart failure CHF OR CHD Cerebrovascular disorders dyspnea paroxysmal edema cardiac Because of automatic term mapping in PubMed, some MeSH terms may have been used even when not explicitly specified. Appendix 2. Author Relationships With Industry and Other Entities (Relevant) 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease Committee Member Employment Consultant Speakers Bureau Ownership/ Partnership/ Principal Personal Research Institutional, Organizational, or Other Financial Benefit Expert Witness Donna K. Arnett, Co-Chair University of Kentucky College of Public Health Dean and Professor of Epidemiology None None None None None None Roger S. Blumenthal, Co-Chair Johns Hopkins University Professor of Medicine and Director, Ciccarone Center for the Prevention of Heart Disease None None None None None None Michelle A. Albert UCSF School of Medicine Professor of Medicine and Director, UCSF NURTURE Center None None None None None None Andrew B. Buroker Faegre Baker Daniels LLP, Partner None None None None None None Zachary D. Goldberger University of Wisconsin School of Medicine and Public Health Associate Professor of Medicine, Division of Cardiology None None None None None None Ellen J. Hahn University of Kentucky College of Nursing Professor & Director, BREATHE, Deputy Director, UK-CARES & Leader, and Community Engagement Core; Marcia A. Dake Professor of Nursing None None None None None None Cheryl Dennison Himmelfarb Johns Hopkins School of Nursing Professor; Associate Dean Research, Office for Science and Innovation; and Deputy Director, Johns Hopkins Institute for Clinical and Translational Research None None None None None None Appendix 1. Continued Medical Subject Headings (MeSH) Terms Key Words (Continued) CLINICAL STATEMENTS AND GUIDELINES Amit Khera UT Southwestern School of Medicine Professor of Internal Medicine and Director, Preventive Cardiology Program None None None None None None Donald Lloyd-Jones Northwestern University Eileen M. Foell Professor; Senior Associate Dean for Clinical and Translational Research; Chair, Department of Preventive Medicine; and Director, Clinical and Translational Sciences Institute None None None None None None J. William McEvoy National University of Ireland, Galway Campus Professor of Preventive Cardiology; National Institute for Preventive Cardiology, Galway Medical and Research Director; and University Hospital Galway, Ireland Consultant Cardiologist. None None None None None None Erin D. Michos Johns Hopkins School of Medicine Associate Professor of Medicine and Associate Director of Preventive Cardiology, Ciccarone Center for the Prevention of Heart Disease; Johns Hopkins Bloomberg School of Public Health Associate Professor of Epidemiology None None None None None None Michael D. Miedema Minneapolis Heart Institute Research Cardiologist None None None None None None Daniel Mu oz Vanderbilt University Medical Center Assistant Professor of Medicine, Division of Cardiology, Medical Director for Quality, Vanderbilt Heart & Vascular Institute, and Associate Medical Director, Cardiovascular ICU None None None None None None Sidney C. Smith Jr University of North Carolina, Chapel Hill Professor of Medicine, Division of Cardiology None None None None None None Salim S. Virani Baylor College of Medicine Professor, Section of Cardiovascular Research and Director for Research, Cardiology Fellowship Training Program; Michael E. DeBakey VA Medical Center Staff Cardiologist and Investigator, Health Policy, Quality & Informatics Program, Center for Innovations in Quality, Effectiveness and Safety None None None None None None Kim A. Williams Sr Rush Medical College James B. Herrick Professor and Chief, Division of Cardiology, Department of Internal Medicine None None None None None None Joseph Yeboah Wake Forest Baptist Health Associate Professor, Internal Medicine, Cardiovascular None None None None None None Boback Ziaeian University of California at Los Angeles/US Department of Veterans Affairs Greater Los Angeles Healthcare System, David Geffen School of Medicine Assistant Professor, Division of Cardiology None None None None None None This table represents the relationships of committee members with industry and other entities that were determined to be relevant to this document. These relationships were reviewed and updated in conjunction with all meetings and/or conference calls of the writing committee during the document development process. The table does not necessarily reflect relationships with industry at the time of publication. A person is deemed to have a significant interest in a business if the interest represents ownership of 5% of the voting stock or share of the business entity, or ownership of $5 000 of the fair market value of the business entity; or if funds received by the person from the business entity exceed 5% of the person s gross income for the previous year. Relationships that exist with no financial benefit are also included for the purpose of transparency. Relationships in this table are modest unless otherwise noted. According to the ACC/AHA, a person has a relevant relationship IF: a) the relationship or interest relates to the same or similar subject matter, intellectual property or asset, topic, or issue addressed in the document; or b) the company/entity (with whom the relationship exists) makes a drug, drug class, or device addressed in the document or makes a competing drug or device addressed in the document; or c) the person or a member of the person s household, has a reasonable potential for financial, professional or other personal gain or loss as a result of the issues/content addressed in the document. ACC indicated American College of Cardiology; AHA, American Heart Association; ICU, Intensive Care Unit; LLP, Limited Liability Partnership; UCSF, University of California, San Francisco; UT, University of Texas; and VA, Veterans Affairs. Appendix 2. Continued Committee Member Employment Consultant Speakers Bureau Ownership/ Partnership/ Principal Personal Research Institutional, Organizational, or Other Financial Benefit Expert Witness CLINICAL STATEMENTS AND GUIDELINES Appendix 3. Reviewer Relationships With Industry and Other Entities (Comprehensive) 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease Reviewer Representation Employment Consultant Speakers Bureau Ownership/ Partnership/ Principal Personal Research Institutional, Organizational, or Other Financial Benefit Expert Witness Salary Amy Peterson Official Reviewer AHA Hospital Affiliations: American Family Children s Hospital; UnityPoint Health Meriter; UW School of Medicine and Public Health Department of Pediatrics None None None None None None None Kim K. Birtcher Official Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Lead Reviewer University of Houston, College of Pharmacy, Clinical Professor Jones & Bartlett Learning None None None Accreditation Council for Clinical Lipidology (Other category) None None Sanjay Gandhi Official Reviewer ACC Metro Health Medical Center Cleveland, Associate Professor, Case Western Reserve University School of Medicine None None None Cleveland Heart Lab Juventas Athersys (Data Safety Monitoring Board) Tendyne (Other category) None None Andrea Price Official Reviewer ACC Science and Quality Committee Quality Databases at Indiana University Health, Director None None None None ACC* None None Jennifer E. Sanner Beauchamp Content Reviewer AHA University of Texas Health Science Center, Cizik School of Nursing, Associate Professor None None None None None None None Glenn N. Levine Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Professor of Medicine at Baylor College of Medicine in Houston, Texas None None None None None Out of hospital cardiopulmonary (Defendant)* Out of hospital (Defendant)* None Patrick T. O Gara Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Director of Strategic Planning for the Cardiovascular Division at Brigham and Women s Hospital, the Watkins Family Distinguished Chair in Cardiology and Professor of Medicine at Harvard Medical School None None None None Edwards Scientific (Other) Medtronic (Other) NIH (Other)* None None Joshua A. Beckman Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Director, Vascular Medicine; Professor of Medicine at Vanderbilt University Aralez Pharmaceuticals* AstraZeneca Pharmaceuticals* Janssen Scientific Affairs* ER Squibb & Sons Boehringer Ingelheim Pharmaceuticals* Merck Sanofi AstraZeneca Pharmaceuticals None Bristol-Myers Squibb* Bayer (Data Safety Monitoring Board)* Novartis Corporation (Data Safety Monitoring Board) Vascular Interventional Advances (Officer, Director, Trustee, or other Fiduciary Role)* EMX JanaCare None None (Continued) CLINICAL STATEMENTS AND GUIDELINES Anita Deswal Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Chief, Cardiology, Michael E. DeBakey VA Medical Center & Baylor College of Medicine, Professor, Baylor College of Medicine None None None NIH* ACC/AHA (Other) Novartis Corporation (Other) AHA Get With The Guidelines Steering Committee (Other) Heart Failure Society of America (Other) Immediate Past Chair and Member, AHA Committee on Heart Failure and Transplantation (Other) NIH (Other) None None Federico Gentile Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Centro Medico Diagnostico Director, Cardiovascular Disease None None None None None None None Jos A. Joglar Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Program Director, Clinical Cardiac Electrophysiology Fellowship Program; Professor, UT Southwestern Medical Center None None None None None None None Duminda N. Wijeysundera Content Reviewer ACC/AHA Task Force on Clinical Practice Guidelines Associate Professor Anesthesia, University of Toronto None None None Canadian Institutes of Health Research* Ministry of Health and Longterm Care of Ontario (Canada)* NIH* PCORI (Data Safety Monitoring Board) None Canadian Institutes of Health Research (Ottawa, Ontario, Canada)* Eileen M. Handberg Content Reviewer ACC Research Professor of Medicine; Director, Clinical Trials Program; Program Director, Florida CARES, UF Health Bristol-Myers Squibb Company None None Aastrom Biosciences* Amorcyte, Inc* Biocardia, Inc* Brigham and Women s Hospital* Capricor* Cytori Therapeutics, Inc.* Department of Defense* Direct Flow Medical* Duke Clinical Research Institute* East Carolina University* Everyfit Inc* MEDTRONIC* Merck & Co., Inc.* Mesoblast Inc* NIH* PCORI* Sanofi Aventis* Amgen (Other) AstraZeneca (Other) Boehringer Ingelheim (Other) Daiichi Sankyo (Other) Gilead Sciences, Inc. (Other) Ionis (Other) Relypsa (Other) None None Prem Soman Content Reviewer ACC Associate Professor of Medicine (Cardiology), Director, Nuclear Cardiology, UPMC Alnylam Pharma None American Society of Nuclear Cardiology* Astellas Pharma US* None None None Eric Stecker Content Reviewer ACC Associate Professor of Medicine, Division of Cardiovascular Medicine School of Medicine, OHSU None None Hygeia / Desi MD* American Heart Association* Medical Research Foundation of Oregon* None None None Appendix 3. Continued Reviewer Representation Employment Consultant Speakers Bureau Ownership/ Partnership/ Principal Personal Research Institutional, Organizational, or Other Financial Benefit Expert Witness Salary (Continued) CLINICAL STATEMENTS AND GUIDELINES Pamela Morris Content Reviewer ACC Professor, Medical University of South Carolina Amgen Inc. Sanofi Regeneron None None None None None None Andrew Freeman Content Reviewer ACC Director, Clinical Cardiology and Operations; Co- Director, Nuclear Cardiology, National Jewish Health None Boehringer Ingelheim* None None None None None Carl J. Lavie Content Reviewer ACC Medical Director, Cardiac Rehabilitation and Prevention, Ochsner Clinic Foundation None Amgen* ER Squibb & Sons Pfizer* Aralez Pharmaceuticals Amarin Pharma Sanofi Aventis* None None None None None James Stein Content Reviewer ACC Director, UW Health Preventive Cardiology Program, Robert Turell Professor in Cardiovascular Research, UW School of Medicine and Public Health Eli Lilly and Company (DSMB) None None None Up To Date (Other) Wisconsin Alumni Research Foundation (Other) None None Heather Johnson Content Reviewer ACC Associate Professor in the Division of Cardiovascular Medicine at the University of Wisconsin School of Medicine and Public Health None None None None Pfizer None None Nanette Wenger Content Reviewer ACC Professor of Medicine, Division of Cardiology, Emory University School of Medicine Janssen Pharmaceuticals, Inc* Amgen AstraZeneca Gilead Sciences Merck None None Gilead Sciences* NHLBI* Pfizer* Society for Women s Health Research* None None None Michael Blaha Content Reviewer AHA Director of Clinical Research, Ciccarone Center for the Prevention of Heart Disease Associate Professor of Medicine, Johns Hopkins Medicine Ferring Pharmaceuticals Regeneron Pharmaceuticals Sanofi-Aventis* Amgen Akcea MedImmune Novartis Novo Nordisk Siemens* ACC None None Aetna Amgen AHA FDA NIH None None None Laurence Sperling Content Reviewer ACC/ AHA Founder and Director of Preventive Cardiology at the Emory Clinic, Co- Director of the Cardiovascular Disease Fellowship Program at Emory, Professor of Medicine (Cardiology) at the Emory University School of Medicine None None None None None None None Seth Martin Content Reviewer ACC/ AHA Director, Advanced Lipid Disorders Program of the Ciccarone Center; Associate Professor of Medicine at Johns Hopkins Medicine Amgen Akcea Therapeutics Quest Diagnostics Sanofi- Regeneron Esperion Novo Nordisk None None Aetna Foundation* Apple* Google* iHealth* Maryland Innovation Initiative* AHA* Corrie Health (Officer, Director, Trustee, or other Fiduciary Role) Co-inventor on pending patent filed by Johns Hopkins University for method of LDL-C estimation (Other) None None Appendix 3. Continued Reviewer Representation Employment Consultant Speakers Bureau Ownership/ Partnership/ Principal Personal Research Institutional, Organizational, or Other Financial Benefit Expert Witness Salary (Continued) CLINICAL STATEMENTS AND GUIDELINES Samia Mora Content Reviewer ACC/ AHA Associate Professor of Medicine, Harvard Medicine School Director, Center for Lipid Metabolomics, Brigham and Women s Hospital Pri-Med* Pfizer Quest Diagnostics None None None C3 Conference (Other) European Atherosclerosis Society (Other) FEBS Congress (Other) Oregon Health & Science University (Other) Vascular Biology Working Group Meeting (Other) Atherotech Diagnostics* Pfizer* Quest Diagnostics* NHLBI* NIDDK* None None Clyde Yancy Content Reviewer ACC/ AHA Chief of Cardiology in the Department of Medicine, Northwestern Medicine None None None None JAMA Cardiology (Other)* None None Quinn Pack AACVPR Assistant Professor of Medicine at University of Massachusetts Medical School None None None None None None None Frank Sacks ASN Professor of Cardiovascular Disease Prevention, Harvard School of Public Health Amgen Pfizer* AstraZeneca* None None None None None None Salvatore Lacagnina ACPM System Medical Director of Wellness & Employee Health, Lee Health None None None None None None None Ron Blankstein ASPC Co-Director, Cardiovascular Imaging Training Program, Associate Physician, Preventive Cardiology, Director, Cardiac Computed Tomography, Brigham Health, Associate Professor in Medicine and Radiology, Harvard Medical School Ekos Corporation Amgen None None Amgen Astellas Sanofi-Aventis American Society of Nuclear Cardiology (Officer, Director, Trustee, or other Fiduciary Role) Intersocietal Accreditation Commission for Computed Tomography (Officer, Director, Trustee, or other Fiduciary Role) Society of Cardiovascular Computed Tomography (Officer, Director, Trustee, or other Fiduciary Role) None None Jo-Ann Eastwood PCNA Associate Professor, UCLA School of Nursing None None None None None None None Stuart Haines Content Reviewer ACC/ AHA Professor of Pharmacy Practice, University of Mississippi None None Rx Instructional Systems* None American Association of Colleges of Pharmacy (Officer, Director, Trustee, or other Fiduciary Role) None None Appendix 3. Continued Reviewer Representation Employment Consultant Speakers Bureau Ownership/ Partnership/ Principal Personal Research Institutional, Organizational, or Other Financial Benefit Expert Witness Salary (Continued) CLINICAL STATEMENTS AND GUIDELINES Michael Rich AGS Professor of Medicine, Washington University School of Medicine in St. Louis None None None None None None None This table represents all relationships of reviewers with industry and other entities that were reported at the time of peer review, including those not deemed to be relevant to this document, at the time this document was under review. The table does not necessarily reflect relationships with industry at the time of publication. A person is deemed to have a significant interest in a business if the interest represents ownership of 5% of the voting stock or share of the business entity, or ownership of $5 000 of the fair market value of the business entity; or if funds received by the person from the business entity exceed 5% of the person s gross income for the previous year. Relationships that exist with no financial benefit are also included for the purpose of transparency. Relationships in this table are modest unless otherwise noted. Names are listed in alphabetical order within each category of review. Please refer to http://www.acc.org/guidelines/about-guidelines-and-clinical-documents/relationships-with- industry-policy for definitions of disclosure categories or additional information about the ACC/AHA Disclosure Policy for Writing Committees. *Significant relationship. No financial benefit. AACVPR indicates American Association of Cardiovascular and Pulmonary Rehabilitation; ACC, American College of Cardiology; ACPM, American College of Preventive Medicine; AGS, American Geriatrics Society; AHA, American Heart Association; ASN, American Society for Nutrition; American Society of Preventive Cardiology; DSMB, Data and Safety Monitoring Board; FDA, US Food and Drug Administration; FEBS, Federation of European Biochemical Societies; JAMA, Journal of the American Medical Association; LDL-C, low-density lipoprotein cholesterol; NHLBI, National Heart, Lung, and Blood Institute; NIDDK, National Institute of Diabetes and Digestive and Kidney Diseases; NIH, National Institutes of Health; OHSU, Oregon Health & Science University; PCNA, Preventive Cardiovascular Nurses Association; PCORI, Patient-Centered Outcomes Research Institute; UCLA, University of California, Los Angeles; UF, University of Florida; UPMC, University of Pittsburgh Medical Center; UT, University of Texas; UW, University of Wisconsin; and VA, Veterans Affairs. Appendix 3. Continued Reviewer Representation Employment Consultant Speakers Bureau Ownership/ Partnership/ Principal Personal Research Institutional, Organizational, or Other Financial Benefit Expert Witness Salary