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Primary and Secondary Prevention Deactivation of Implantable Cardioverter Defibrillator Extravasation of IV Amiodarone Anticoagulation for AF, DVT and PE Patients Returning from Interventional Cardiac Procedure Cardiology Referrals STEMI Thrombolysis Protocol STEMI Hypertensive Emergencies Rate Control in AF Heart Failure Aortic Dissection Non ST Elevation MI (NSTEMI) Suspected Acute Coronary Syndrome Pericardiocentesis Pacemakers Indications for Echocardiography Bradycardia Narrow Complex Tachycardia Anti-Platelet Therapy in Coronary Heart Disease Management of Acute AF Rhythm Control in AF Atrial Fibrillation Hypertension Ventricular Tachycardia Cardiogenic Shock Complicating Acute Coronary Syndrome Telemetry
Home | Articles | Cardiac | Primary and Secondary Prevention

Primary and Secondary Prevention

Last updated 27th March 2025

Introduction

  1. A local working group headed by Ciara Wannop, Stewarty Lead Cluster Pharmacist, have recently (March 2025) published a guideline on the Primary and Secondary Prevention of Coronary Heart Disease and Stroke.
  2. This is primarily about the management of hyperlipidaemia and can be accessed by clicking the link below
  3. Coronary Heart Disease and Stroke, Primary and Secondary Prevention Guideline (Cholesterol)

Primary Prevention

  1. For patients with a 10 year cardiovascular event ASSIGN risk ≥20% offer atorvastatin 20mg daily
  2. There are no targets for cholesterol in primary prevention
  3. It is good practice to recheck full lipid profile within 3 months of initiation & optimise treatment where appropriate
  4. There is no need for annual bloods

Secondary Prevention

  1. For patients with previous MI, previous CABG or PCI, angina, proven coronary artery disease (invasive or CT angiography), ischaemic stroke, TIA or peripheral artery disease offer atorvastatin 80mg od or maximum tolerated dose of statin
  2. The target for secondary prevention is a calculated LDL goal <2mmol/L
  3. Full non fasting lipid profile and LFT should be measured within 3 months of starting treatment and at each titration until optimised

Links

  1. NHS Statin Intolerance Pathway

Content by Ciara Wannop and Chris Isles