Please listen as Drs. Pradeep, Blankenstein, and Nasir discuss the changes in 2018 guidelines compared to the 2013 guidelines, specifically with respect to coronary artery calcium scoring, the increased focus on having a risk discussion between patients and clinicians in order to decide on the role of therapy, and the emphases on the role of calcium testing as a guide to flexible choices of statin therapy, rather than as a screening tool.