Lipid modification is recommended for all patients with existing cardiovascular disease without the need for formal risk assessment because they are at increased risk of CVD.

NICE advises use of a high intensity statin such as atorvastatin 80mg daily for the secondary prevention of CVD.¹⁴

Patients should be counselled on the possible side effects associated with statins including myopathy and rhabdomyolysis. Generally the side effects of statins are mild, readily reversible and not considered medically serious although patients may still find them distressing.

Patients should be counselled on the appropriate time of day to take their statins i.e. with the exception of atorvastatin they should be taken at night.

NICE advises that vitamin or fish oil supplements should not be prescribed in the treatment of angina due to a lack of evidence of efficacy.¹

¹⁴ Clinical Knowledge Summaries: Lipid modification - CVD Prevention. NICE. http://cks.nice.org.uk/lipid-modification-cvd-prevention#!scenariorecommendation:6. Revised October 2015.