Risk factors for CVD include non-modifiable factors such as age, sex, family history of CVD, ethnic background and modifiable risk factors such as smoking, raised blood pressure and cholesterol. CVD is strongly associated with low income and social deprivation and shows a North South divide, with higher rates in the north of England. This guideline includes recommendations on risk assessment for CVD and on the use of lipid-lowering drugs. The original guideline is updated in part to allow consideration of new evidence on risk assessment tools and to reflect changes in price and availability of generic statins. NICE has produced guidance on other modifiable risk factors for CVD and this guideline should be used in conjunction with it. In this update the guideline development group recommend the use of non-high-density lipoprotein (non-HDL) cholesterol rather than low-density lipoprotein (LDL) cholesterol. Non-HDL cholesterol is total cholesterol minus HDL cholesterol. LDL cholesterol is not directly measured but requires a calculation using a fasting sample and for triglyceride levels to be less than 4.5 mmol/litre, whereas the measurement of non-HDL cholesterol does not. For the purpose of this guideline, statins are grouped into 3 different intensity categories according to the percentage reduction in low-density lipoprotein cholesterol they produce: low intensity if the reduction is 20% to 30% medium intensity if the reduction is 31% to 40% high intensity if the reduction is above 40%. Please see appendix A for further details. This grouping was agreed by guideline development group consensus, informed by analyses in the literature. See also the full guideline for a discussion of this grouping. Recommendations People have the right to be involved in discussions and make informed decisions about their care, as described in NICE's information on making decisions about your care. 