### What you need to know
While mortality from acute cardiovascular disease (CVD) has been falling in most developed countries, more people are now living with established CVD, including coronary heart disease, peripheral arterial disease, and stroke or transient ischaemic attack. These individuals remain at high risk of subsequent cardiovascular events and mortality. In the UK, the cost of treating a myocardial infarction is £1310 higher in the first year for someone with established CVD than for a first event.1 Secondary prevention interventions, such as lowering of low density lipoprotein cholesterol (LDL-C), mitigate this risk and improve outcomes.2
Statins, ezetimibe, bempedoic acid, and injectable therapies are approved as lipid lowering therapies in the UK. However, use of these agents is variable,3 with about one fifth of people with CVD in England receiving no lipid lowering therapy.4 This is partly because of the absence of nationally agreed LDL-C targets for people with C
### What you need to know
Liver cirrhosis affects 110 people per 100 000 in the UK1 and is closely linked with deprivation. The British Liver Trust2 estimates premature deaths from liver disease to be four times higher in the most deprived areas compared with the most affluent. Early identification and management can delay decompensation events such as variceal bleeding, ascites, and hepatic encephalopathy, leading to longer, better quality life for people with liver disease.
In 2015, the National Institute for Health and Care Excellence (NICE) first published guidance on the assessment and early management of cirrhosis in people over 16. This article summarises updated 2023 recommendations, focusing on managing complications, and appraises new evidence related to the effectiveness of non-selective beta blockers (NSBBs) for the primary prevention of decompensation in people with cirrhosis.3 The new guidance also updates recommendations about prevention of variceal bleeding in peopl