What are the current guidelines for the use of statins in primary prevention of cardiovascular disease related to atherosclerosis?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For primary prevention of cardiovascular disease, NICE recommends offering atorvastatin 20 mg to people with a 10‑year QRISK3 score of 10% or more .

Before initiating statin treatment, discuss the benefits of lifestyle changes and optimise management of all modifiable risk factors .

If lifestyle changes are ineffective or inappropriate, then statin treatment should be offered .

People should be informed that any statin at any dose reduces CVD risk .

In people aged 85 and older, consider treatment with atorvastatin 20 mg, taking into account individual factors that may make treatment inappropriate .

Statins are contraindicated in pregnancy and should be stopped if pregnancy is possible or planned, and not restarted until breastfeeding is finished .

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