Heart attack and stroke are major causes of mortality and morbidity in developed countries but in the last two decades lifestyle, clinical and pharmaceutical endeavour have reduced age-adjusted cardiovascular disease rates. As longevity increases, however, macrovascular disease risk also increases. Unfortunately, two lifestyle changes – lack of exercise and increasing obesity – are in the wrong direction, aggravating hyperlipidaemia, hypertension, diabetes mellitus and insulin resistance. Thus, major challenges are still present, highlighted in the National Service Frameworks (NSFs) for coronary heart disease and diabetes. To maximise their contributions to these problems, the British Hyperlipidaemia Association (BHA) and Family Heart Association (FHA) have merged to form the Hyperlipidaemia Education And Research Trust – HEART UK. Both associations have been concerned with scientific, medical and social issues of cholesterol and lipids in the UK. HEART UK marks a substantial move forward for scientific lipid study, for recognition of the high-risk individual, and for patient treatment.