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.

This guideline does not cover people with familial hypercholesterolaemia (FH). For guidance on FH, see NICE’s guideline on familial hypercholesterolaemia: identification and management.

In May 2023, we reviewed the evidence and made new/updated recommendations on risk assessment tools for primary prevention of CVD, cardioprotective diets, and statin treatment for primary and secondary prevention of CVD. For further details, see the update information.


This guideline includes recommendations on:

 Who is it for?

  • Healthcare professionals
  • People who are at risk of CVD or who have had CVD

Is this guideline up to date?

Updates in progress:

Guideline development process

How we develop NICE guidelines

This guideline updates and replaces NICE guideline CG67 (September 2008) and NICE technology appraisal guidance 94 (January 2006).

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

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.

  • National Institute for Health and Care Excellence (NICE)