Because the price of statins has fallen, using statins to reduce the risk of CVD at a lower threshold than NICE previously recommended is cost effective. Primary healthcare professionals may need to change their practice. Challenges for implementation The number of people eligible to take statins for the primary prevention of CVD will increase because of the reduction in the treatment threshold from a 20% to a 10% 10-year risk of a CVD event. The challenge is to ensure that statin treatment is presented as a patient choice in addition to lifestyle modification to avoid unnecessarily 'medicalising' this group of people. To help patients make an informed decision, healthcare professionals will need an effective way of briefly but clearly communicating the pros and cons of the various options available. Support for implementation The guideline does not propose that statins should be used instead of the lifestyle adjustments that people at risk need to make. It encourages GPs to fully explore with their patients all the options promoted by the guidance, including lifestyle changes, blood pressure control, avoidance of diabetes and cholesterol (lipid) lowering. There is a NICE patient decision aid to support primary healthcare professionals in discussing the pros and cons of statin therapy with their patients so they can make an informed choice. Expert opinion suggests that around 20% of these people will choose not to take statins after discussions with their healthcare professional. Health practitioners may wish to refer to the lifestyle modification information in NICE's guideline on behaviour change: individual approaches. Atorvastatin for the primary and secondary prevention of CVD Potential impact of implementation Since the 2008 guideline on lipid modification was published, atorvastatin has come off- patent and is available at a reduced cost, therefore making it more cost effective. 