Patients with a 10 per cent or greater risk of developing cardiovascular disease (CVD) within the next 10 years should be offered lifestyle advice ahead of statins, according to a new quality standard from NICE.

The quality standard on cardiovascular risk assessment and lipid modification follows guidance on statin therapy, which was published last year.

CVD is the leading cause of death in England and Wales, accounting for almost a third of all deaths.

While mortality from CVD has fallen in recent years due to a reduction in risk factors such as smoking, CVD morbidity appears to be on the rise and cost the NHS an estimated £7,880 million in 2010. The disease is  strongly associated with health inequalities and is more prevalent in areas of high social deprivation.

The quality standard advises prescribers to use the formal risk assessment tool QRISK2 to estimate a patient's risk of CVD and to discuss the benefits of lifestyle interventions before offering statin therapy.

Those who opt for statin therapy should be offered atorvastatin 20mg for the primary prevention of the disease, while adults with newly diagnosed CVD should be offered atorvastatin 80mg.