Cardiovascular disease: risk assessment and reduction, including lipid modification

Update information

December 2023: This guideline updates and replaces NICE guideline CG181 (July 2014). We reviewed the evidence and made a new recommendation on the target lipid level for secondary prevention of CVD for adults on lipid-lowering treatment. New recommendations are marked [December 2023]. We also restructured the guideline to provide better navigation. Some of the existing recommendations have been amended to be consistent with the new recommendations or for clarification because of the restructure.

Recommendations marked [date 1, amended date 2] had an evidence review in date 1.

May 2023: We reviewed the evidence and made new recommendations on risk assessment tools for primary prevention of CVD, cardioprotective diets and statin treatment for primary prevention of CVD. Recommendations for chronic kidney disease and initial treatment with statins for secondary prevention of CVD were not changed.

February 2023: We added a new recommendation on aspirin for primary prevention of CVD. This is based on a 2023 surveillance decision.

July 2014: This guideline updates and replaces NICE guideline CG67 and NICE technology appraisal guidance 94.

Minor changes since publication

September 2025: We added links to relevant technology appraisal guidance in the sections on lipid-lowering treatment for primary prevention of CVD, lipid-lowering treatment for secondary prevention of CVD, treatment if statins are contraindicated or not tolerated and lipid-lowering treatments that should not be used or not used routinely.

ISBN: 978-1-4731-5636-4