Update information

Update information

September 2016: Recommendation 1.3.28 was amended to clarify what was meant by high-intensity statin treatment, and that the recommendation applies to both primary and secondary prevention. The term 'high-intensity statin' was also added to the 'Terms used in this guideline' section and linked to throughout.

January 2015: New section Implementation: getting started added.

July 2014: This guideline updated and replaced NICE guideline CG67 (published September 2008). It also updated and replaced recommendations relating to statin therapy for people at increased risk of developing cardiovascular disease or those with established cardiovascular disease in statins for the prevention of cardiovascular events (NICE technology appraisal guidance 94, 2006).

Recommendations marked [new 2014] or [2014] last had an evidence review in 2014. Recommendations marked [2008] or [2008, amended 2014] last had an evidence review in 2008.

In some cases, minor changes were made to the wording to bring the language and style up to date, without changing the meaning.

We also made some changes without an evidence review:

  • The age range was removed from recommendation 1.1.1 for clarity.

  • The threshold for treatment in recommendations 1.1.4, 1.1.17 and 1.1.19 has been changed because of new health economics results.

  • Recommendation 1.1.15 was amended to include all cardiovascular diseases.

  • In recommendation 1.1.16, the bullet point about type 2 diabetes was deleted because the committee made separate specific recommendations for this subgroup.

  • The list of underlying medical conditions in recommendation 1.1.18 has been updated.

  • In recommendation 1.1.21, the age value has been changed to 85, as this is the upper limit of the QRISK2 assessment tools. The part on treatment has been deleted, as recommendations on treatment are listed in section 1.3.

  • In recommendation 1.2.27, the words 'long term' have been added to emphasise the need to discuss people's views about taking medication long term.

  • Recommendation 1.1.28 has been amended to highlight the importance of the person's involvement in decision making and that their choices are adequately recorded.

  • Recommendations 1.2.7 and 1.2.9 were updated because the chief medical officer issued changes to recommendations on physical activity in 2011.

  • In recommendation 1.3.22, the reference to fasting was deleted because the committee considered that a fasting sample is not necessary if non-high-density lipoprotein (HDL) cholesterol is measured (see recommendation 1.3.4). They also wished to highlight the importance of taking a lipid sample also on admission.

These recommendations are marked [2008, amended 2014].

Minor changes since publication

July 2022: Recommendations 1.3.48 to 1.3.50 have been updated in line with NICE's technical appraisal guidance on icosapent ethyl with statin therapy for reducing the risk of cardiovascular events in people with raised triglycerides.

April 2022: Changed heading for recommendations 1.3.3 to 1.3.11 to clarify that these cover initial lipid measurement and referral for specialist review.

January 2022: Minor changes to redirect NICE Pathways links.

November 2021: We added a link to NICE's shared decision making guideline in recommendation 1.1.22.

October 2021: We added a link to other treatment options in NICE's technology appraisal guidance on lipid disorders (see end of recommendations section).

November 2020: The link in recommendations 1.2.7 and 1.2.8 was replaced with a link to the 2019 UK Chief Medical Officers' physical activity guideline. Footnotes were incorporated into the text and the table in appendix A redrawn in line with accessibility guidance.

June 2020: The recommendation on alcohol consumption was updated to bring it in line with the UK chief medical officers' guidelines on low-risk drinking. Links were added to the patient decision aid on taking a statin to reduce the risk of coronary heart disease and stroke.

August 2018: A link to the NICE guideline on physical activity: exercise referral schemes was added to recommendation 1.3.15.

February 2018: In recommendation 1.1.20, a link was updated to go to the NICE guideline on obesity. In recommendation 1.2.10, links were updated to go to the NICE guidelines on walking and cycling, physical activity, and exercise referral schemes to promote physical activity. In recommendation 1.2.12, a link was updated to go to the NICE guideline on obesity. In recommendation 1.3.13, a link was updated to go to the NICE guideline on obesity.

July 2016: Amended recommendation 1.2.2 to clarify the advice on saturated and monounsaturated fat.

December 2015: Changes to update information and recommendation labelling after publication of the updated NICE guideline on type 2 diabetes in adults.

August 2015: Changes to recommendation labelling, footnote 7, and update information following publication of updated NICE guidelines on chronic kidney disease and type 1 diabetes in adults.

ISBN: 978-1-4731-0638-3

  • National Institute for Health and Care Excellence (NICE)