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Background: Atherosclerotic cardiovascular disease (ASCVD) is a major contributor to nationwide morbidity, mortality, and healthcare costs in the United States. Over 92 million adults have at least one form of ASCVD, and annual costs for treatment are anticipated to surpass one trillion dollars within the next 15 years. Objective: The objective of this study was to evaluate the medication therapy of a population of adults in comparison to the American College of Cardiology/American Heart Association (ACC/AHA) recommendations for statin therapy for ASCVD risk reduction. Methods: The adult population receiving care from a group of hospital outpatient clinics was examined using a database query. Rates of ASCVD in a multicounty area were compared and provider adherence to current guidelines was assessed. Results: Rural counties showed higher rates of ASCVD. Rates of statin medication prescribing for patients of each ACC/AHA statin benefit group ranged from 66.2% to 74.8%. Conclusions and Implications for Nurse Practitioners: Adherence to guidelines varied among counties and optimal adherence was not achieved. Providers were also more likely to prescribe statin medications to men than women within each group regardless of risk. These findings can assist nurse practitioners and other providers in addressing areas of nonadherence to guidelines. [ABSTRACT FROM AUTHOR]