[2008, amended 2014] 1.1.17 When using the risk score to inform drug treatment decisions, particularly if it is near to the threshold for treatment, take into account other factors that: may predispose the person to premature CVD and may not be included in calculated risk scores. [2008, amended 2014] 1.1.18 Recognise that standard CVD risk scores will underestimate risk in people who have additional risk because of underlying medical conditions or treatments. These groups include: people treated for HIV people with serious mental health problems people taking medicines that can cause dyslipidaemia such as antipsychotic medication, corticosteroids or immunosuppressant drugs people with autoimmune disorders such as systemic lupus erythematosus, and other systemic inflammatory disorders. [2008, amended 2014] 1.1.19 Recognise that CVD risk will be underestimated in people who are already taking antihypertensive or lipid modification therapy, or who have recently stopped smoking. Use clinical judgement to decide on further treatment of risk factors in people who are below the CVD risk threshold for treatment. [2008, amended 2014] 1.1.20 Severe obesity (BMI greater than 40 kg/m2 ) increases CVD risk. Take this into account when using risk scores to inform treatment decisions in this group (see NICE's guideline on obesity: identification, assessment and 1.1.21 Consider people aged 85 or older to be at increased risk of CVD because of age alone, particularly people who smoke or have raised blood Communication about risk assessment and treatment 1.1.22 NICE has produced guidance on the components of good patient experience in adult NHS services. These include recommendations on the communication of risk. Follow the recommendations in NICE's guideline on patient experience in adult NHS services. See also NICE's guideline on shared decision making. [2014] 1.1.23 Use everyday, jargon-free language to communicate information on risk. If technical terms are used, explain them clearly. 