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Cardiovascular disease - statins - NICE TAG TA94

This guidance relates only to the initiation of statin therapy in adults with clinical evidence of cardiovascular disease (CVD) and in adults considered to be at risk of CVD. It assumes that other strategies for managing CVD risk are being appropriately considered when initiating statin therapy. The guidance does not include specific advice for genetic dyslipidaemias (for example, familial hypercholesterolaemia). The guidance relates only to the use of statins within their licensed indications.

A clinical guideline on cardiovascular risk assessment has been published (Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease, NICE clinical guideline 67). This guidance should be read in the context of the clinical guideline.

1.1 Statin therapy is recommended for adults with clinical evidence of CVD.

1.2 Statin therapy is recommended as part of the management strategy for the primary prevention of CVD for adults who have a 20% or greater 10-year risk of developing CVD. This level of CVD risk should be estimated using an appropriate risk calculator, or by clinical assessment for people for whom an appropriate risk calculator is not available (for example, older people, people with diabetes or people in high-risk ethnic groups).

1.3 Within the recommendations outlined in Section 1.1 and Section 1.2, the decision whether to initiate statin therapy should be made after an informed discussion between the responsible clinician and the individual about the risks and benefits of statin treatment, and taking into account additional factors such as comorbidities and life expectancy.

1.4 When the decision has been made to prescribe a statin, it is recommended that therapy should usually be initiated with a drug with a low acquisition cost (taking into account required daily dose and product price per dose).


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