Estimate the level of risk using the QRISK2 assessment tool. [2014] For information about implementing this recommendation, see implementation: getting started. 1.4.19 For people 85 years or older consider atorvastatin 20 mg as statins may be of benefit in reducing the risk of non-fatal myocardial infarction. Be aware of factors that may make treatment inappropriate (see Secondary prevention 1.4.20 Start statin treatment in people with CVD with atorvastatin 80 mg. Use a lower dose of atorvastatin if any of the following apply: potential drug interactions high risk of adverse effects patient preference. [2014] In July 2014, this was an off-label use of atorvastatin. See NICE's information on prescribing medicines. For information about implementing this recommendation, see the implementation: getting started section. 1.4.21 Do not delay statin treatment in secondary prevention to manage modifiable risk factors. [2014] 1.4.22 If a person has acute coronary syndrome, do not delay statin treatment. Take a lipid sample on admission and about 3 months after the start of Primary prevention for people with type 1 diabetes 1.4.23 Consider statin treatment for the primary prevention of CVD in all adults with type 1 diabetes. [2014] 1.4.24 Offer statin treatment for the primary prevention of CVD to adults with type 1 diabetes who: are older than 40 years or have had diabetes for more than 10 years or have established nephropathy or have other CVD risk factors. [2014] 1.4.25 Start treatment for adults with type 1 diabetes with atorvastatin 20 mg. Primary prevention for people with type 2 diabetes 1.4.26 Offer atorvastatin 20 mg for the primary prevention of CVD to people with type 2 diabetes who have a 10% or greater 10-year risk of developing CVD. 