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### 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
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