This National Institute for Health and Care Excellence (NICE) 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.
Death rates from CVD peaked in the 1970s and 1980s but have more than halved since then. Rates have fallen more rapidly in older age groups compared with younger ones, with an approximately 50% reduction in the 55–64 year age group compared with a 20% reduction in men aged 35–44 years. In spite of evidence that mortality from CVD is falling, morbidity appears to be rising.
CVD shows strong age dependence and predominantly affects people older than 50 years. Risk factors for CVD include non‑modifiable factors such as:
Modifiable risk factors include:
CVD is strongly associated with low income and social deprivation and shows a north–south divide, with higher rates in the north of England.
This guideline includes recommendations on risk assessment for CVD and on the use of lipid‑lowering drugs. The original guideline is updated in part to allow consideration of new evidence on risk assessment tools and to reflect changes in price and availability of generic statins.
NICE has produced guidance on other modifiable risk factors for CVD and this guideline should be used in conjunction with it.
You can read the guideline on NICE's website.