[2014] 1.4.25 Start treatment for adults with type 1 diabetes with atorvastatin 20 mg. Primary prevention for people with type 2 diabetes 1.4.26 Offer atorvastatin 20 mg for the primary prevention of CVD to people with type 2 diabetes who have a 10% or greater 10-year risk of developing CVD. Estimate the level of risk using the QRISK2 assessment People with CKD 1.4.27 Offer atorvastatin 20 mg for the primary or secondary prevention of CVD to people with CKD. Increase the dose if a greater than 40% reduction in non-HDL cholesterol is not achieved (see recommendation 1.3.28) and eGFR is 30 ml/min/1.73 m2 or more. Agree the use of higher doses with a renal specialist if eGFR is less than 30 ml/ See NICE's guideline on chronic kidney disease for CKD classification. People on renal replacement therapy are outside the scope of this guideline. Follow-up of people started on statin treatment 1.4.28 Measure total cholesterol, HDL cholesterol and non-HDL cholesterol in all people who have been started on high-intensity statin treatment (both primary and secondary prevention, including atorvastatin 20 mg for primary prevention) at 3 months of treatment and aim for a greater than 40% reduction in non-HDL cholesterol. If a greater than 40% reduction in non-HDL cholesterol is not achieved: discuss adherence and timing of dose optimise adherence to diet and lifestyle measures consider increasing the dose if started on less than atorvastatin 80 mg and the person is judged to be at higher risk because of comorbidities, risk score or using clinical judgement. [2014] 1.4.29 Provide annual medication reviews for people taking statins. Use these reviews to discuss medicines adherence and lifestyle modification and address CVD risk factors. Consider an annual non-fasting blood test for non-HDL cholesterol to inform the discussion. 