Cardiovascular disease (CVD) is the leading cause of death in England and Wales, and accounts for almost one-third of deaths,1 with the majority of these related to ischaemic heart disease. There is some evidence to suggest that CVD mortality is decreasing, but morbidity is increasing.
Non-modifiable CVD risk factors include age, sex, ethnicity and family history. These should be assessed, together with modifiable risk factors such as smoking, hypertension and raised cholesterol levels.
NICE highlights the strong association of CVD with low income and social deprivation, and the north-south divide: there is an increased rate of CVD in the north of England.
The latest NICE guidance advises using non-high-density lipoprotein (non-HDL) rather than low-density lipoprotein (LDL) cholesterol levels.1
Non-HDL cholesterol is total cholesterol minus HDL cholesterol. A fasting sample is required for measuring LDL cholesterol and triglyceride levels must be <4.5mmol/l, whereas this is not the case when measuring non-HDL cholesterol.