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The National Institute for Health and Care Excellence (NICE) has published new guidance on the use of daily cholesterol-lowering statin pills, advising that they can now be considered for more people to reduce their risk of having a heart attack or stroke.

Up until now, NICE has recommended that those with a 10% or higher risk over ten years of a cardiovascular event should be offered a statin – guidance that remains unchanged.

Now, it is also recommending that statins can be considered as part of shared decision-making for those who have not had a cardiovascular disease (CVD) event with a ten-year CVD risk score of less than 10%.

The change comes after the independent committee updating the NICE guideline on CVD risk assessment and reduction considered new evidence on the side effects and safety of statins.

“The evidence is clear, in our view, that for people with a risk of 10% or less over ten years, statins are an appropriate choice to reduce that risk,” said Paul Chrisp, director of the Centre for Guidelines at NICE.

NICE estimates that under the new recommendation, for every 1,000 people with a risk of 5% over the next ten years who take statins, about 20 people will not get heart disease or have a stroke.

This figure doubles to 40 for people with a risk of 10%, and to around 70 for those with a risk of 20%.

CVD is the leading cause of death in the UK, resulting in around 160,000 deaths each year, and high cholesterol is a significant risk factor for CVD.

People can be at risk from CVD because of factors they cannot change, such as age or family history, but the draft guidance continues to recommend that risk factors which can be addressed should be managed. These include stopping smoking, reducing alcohol consumption, exercising and maintaining a healthy diet.

British Heart Foundation medical director, Professor Sir Nilesh Samani, said: “Research has shown that statins are largely safe. However, the decision to start this medication, which needs to be taken on a long-term basis, is very much a personal choice.

“The decision should be based on a conversation with your GP, and should be combined with other measures such as eating a healthy diet and exercising regularly to get the most benefit.”