Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Contents Overview 4 Who is it for? 4 1.1 Identifying and assessing cardiovascular disease (CVD) risk 7 1.2 Aspirin for primary prevention of CVD 11 1.3 Lifestyle modifications for the primary and secondary prevention of CVD 11 1.4 Lipid modification therapy for the primary and secondary prevention of CVD 15 Terms used in this guideline 25 Implementation: getting started 26 Measuring non-high-density lipoprotein cholesterol when lipid profiling for the primary prevention of cardiovascular disease 26 Reduction of the primary prevention threshold from 20% to 10% CVD risk as calculated by Atorvastatin for the primary and secondary prevention of CVD 28 Further resources 29 Recommendations for research 30 1 Simplifying risk assessment 30 2 Cost effectiveness using individual patient-level data 30 3 Statin therapy in older people 31 4 Lipid modification therapy in people with type 1 diabetes 31 5 Comparative effectiveness and risks of alternative doses of atorvastatin 31 Appendix A: Grouping of statins 33 Finding more information and committee details 36 Update information 37 This guideline replaces CG67 and TA94. This guideline partially replaces CG87. This guideline is the basis of QS100, QS5, QS208 and QS209. Overview This guideline covers the assessment and care of adults who are at risk of or who have cardiovascular disease (CVD), such as heart disease and stroke. It aims to help healthcare professionals identify people who are at risk of cardiovascular problems including people with type 1 or type 2 diabetes, or chronic kidney disease. It describes the lifestyle changes people can make and how statins can be used to reduce their risk. Who is it for? 