How we made the decision

We check our guidelines regularly to ensure they remain up to date. We based the decision on surveillance 4 years after the publication of NICE's guideline on cardiovascular disease (NICE guideline CG181) in 2014.

For details of the process and update decisions that are available, see ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual.


We found 198 studies in a search for systematic reviews and randomised controlled trials published between 11 November 2013 and 15 March 2017. Observational studies were considered for review questions where they were included in the original protocol. We also included 15 relevant studies from a total of 35 identified by members of the guideline committee who originally worked on this guideline. A further study was identified through post-publication communications.

From all sources, we considered 214 studies to be relevant to the guideline.

We also checked for relevant ongoing research, which will be evaluated again at the next surveillance review of the guideline.

See appendix A: summary of evidence from surveillance for details of all evidence considered, and references.

Views of topic experts

We considered the views of topic experts, including those who helped to develop the guideline and other correspondence we have received since the publication of the guideline.

Views of stakeholders

Stakeholders commented on the decision to update the guideline. Overall, 17 stakeholders commented. See appendix B for stakeholders' comments and our responses.

Seventeen stakeholders commented on the proposal to update the guideline: 14 agreed with the decision and 3 noted that they had no comments on the proposals. There was a representative mix of patient organisations, professional bodies, private sector institutions and providers of services. These included the Association of British Clinical Diabetologists, Royal College of Nursing, clinical commissioning groups, Public Health England and HEART UK.

Several comments suggested changes to make to the review questions proposed for updating. These included a suggestion to review the recommendation relating to target based statin treatment, which will be considered in the update process. In addition, extensions to the scope were suggested, some of which were outside the remit of the guideline.

See ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual for more details on our consultation processes.

NICE Surveillance programme project team

Kay Nolan
Associate Director

Martin Allaby
Consultant Clinical Adviser

Emma McFarlane
Technical Adviser

Stephen Sharp
Technical Analyst

The NICE project team would like to thank the topic experts who participated in the surveillance process.

ISBN: 978-1-4731-2858-3

This page was last updated: 25 January 2018