The lipid-lowering trials have shown positive results in terms of reducing cardiovascular events. It is mandatory to measure lipid levels in patients with other cardiovascular risk factors, such as diabetes and hypertension. Explaining cardiovascular risk and lifestyle changes takes longer than the standard 7–9 minute consultation and might be more appropriate in a nurse-led clinic. Good communication between GPs and specialists can still be difficult to achieve: face-to-face meetings are helpful and email should be playing a major role. The National Service Framework for CHD prevention puts a great deal of pressure on GPs. Secondary prevention is non-controversial although ideal levels of LDL are not being reached.