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. Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. 1.1 Identifying and assessing cardiovascular disease (CVD) risk Identifying people for full formal risk assessment 1.1.1 For the primary prevention of CVD in primary care, use a systematic strategy to identify people who are likely to be at high risk. [2008, 1.1.2 Prioritise people on the basis of an estimate of their CVD risk before a full formal risk assessment. Estimate their CVD risk using CVD risk factors already recorded in primary care electronic medical records. [2008] 1.1.3 People older than 40 should have their estimate of CVD risk reviewed on an ongoing basis. [2008] 1.1.4 Prioritise people for a full formal risk assessment if their estimated 10-year risk of CVD is 10% or more. [2008, amended 2014] 1.1.5 Discuss the process of risk assessment with the person identified as being at risk, including the option of declining any formal risk 1.1.6 Do not use opportunistic assessment as the main strategy in primary care to identify CVD risk in unselected people. [2008] Full formal risk assessment 1.1.7 Be aware that all CVD risk assessment tools can provide only an approximate value for CVD risk. Interpretation of CVD risk scores should always reflect informed clinical judgement. [2008] 1.1.8 Use the QRISK2 risk assessment tool to assess CVD risk for the primary prevention of CVD in people up to and including age 84 years. 