The Scottish Intercollegiate Guideline Network (SIGN) has published five new guidelines on heart disease with the aim of helping reach the Scottish Executive’s target of reducing deaths from coronary heart disease (CHD) in those aged under 75 years by 60% for the period 1995–2010. It is hoped the new guidance will help further reduce mortality, which has already fallen by one third between 1995 and 2005. The new guidance covers acute coronary syndromes (SIGN 93), cardiac arrhythmias in coronary heart disease (SIGN 94), the management of chronic heart failure (SIGN 95), the management of stable angina (SIGN 96), and risk estimation and the prevention of cardiovascular disease (SIGN 97). The full guidance is available at www.sign.ac.uk. Here, Dr Alan Begg gives a primary care perspective on the new guidance.