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NICE Guidance
Conditions and diseases
Cardiovascular conditions
Acute coronary syndromes
Cardiovascular disease: risk assessment and reduction, including lipid modification
Clinical guideline [CG181]
Published date:
July 2014
Last updated:
September 2016
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Do not use a risk assessment tool to assess CVD risk in people with an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m2 and/or albuminuria. These people are at increased risk of CVD.
Do not do
December 2016
Unclassified
A fasting sample is not required when taking samples before starting lipid modification therapy for the primary prevention of CVD. Take at least 1 lipid sample to measure a full lipid profile.
Do not do
December 2016
Unclassified
Do not use opportunistic assessment as the main strategy in primary care to identify CVD risk in unselected people.
Do not do
December 2016
Unclassified
Do not use a risk assessment tool to assess CVD risk in people with type 1 diabetes.
Do not do
December 2016
Unclassified
Do not use a risk assessment tool for CVD, for people with pre-existing CVD.
Do not do
December 2016
Unclassified
Do not use a risk assessment tool for people who are at high risk of developing CVD because of familial hypercholesterolaemia.
Do not do
December 2016
Unclassified
Do not advise any of the following to take plant stanols or sterols for the prevention of CVD: people who are being treated for primary prevention, people who are being treated for secondary prevention, people with CKD, people with type 1 diabetes, people with type 2 diabetes.
Do not do
December 2016
Unclassified
Do not delay statin treatment in secondary prevention to manage modifiable risk factors.
Do not do
December 2016
Unclassified
Do not delay statin treatment if a person has acute coronary syndrome. Take a lipid sample on admission and about 3 months after the start of treatment.
Do not do
December 2016
Unclassified
Do not start statin treatment if creatine kinase levels are more than 5 times the upper limit of normal, in 2 tests 7 days apart. Perform these tests when considering starting statin treatment for people who have had persistent generalised unexplained muscle pain (with or without lipid-loewring therapy).
Do not do
December 2016
Unclassified
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