Which statin dose is used for secondary prevention according to NICE guidance?

• A. Atorvastatin 80 mg
• B. Simvastatin 40 mg
• C. Rosuvastatin 20 mg
• D. Pravastatin 40 mg

Answer: (A)

Secondary prevention aims to prevent further cardiovascular events in people with established disease, so NICE recommends high‑intensity statin therapy. Atorvastatin 80 mg daily is the classic high‑intensity option supported by NICE for secondary prevention, delivering about a 50% reduction in LDL cholesterol and strong evidence for lowering recurrent events. The other listed doses are not considered high‑intensity in this context (simvastatin 40 mg and pravastatin 40 mg are lower intensity), so they don’t align as well with NICE’s target for secondary prevention. Rosuvastatin 20 mg is also high‑intensity and can be used if atorvastatin isn’t suitable, but among the options, atorvastatin 80 mg is the representative NICE‑recommended high‑intensity choice.