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Introduction

Twenty-five years ago, Geoffrey Rose [1] pointed out that, in a given community, most cardiovascular deaths will come from individuals at moderate risk because they are so numerous. Nevertheless, high-risk individuals gain most from risk factor modification and are therefore given the highest priority in clinical practice.

What is high risk?

The current European guidelines on cardiovascular disease (CVD) prevention [2] define high risk as: (i) patients with established coronary heart disease, peripheral artery disease and cerebrovascular atherosclerotic disease; (ii) asymptomatic individuals who are at high risk of developing atherosclerotic cardiovascular disease because of: multiple risk factors resulting in a 10-year risk of 5% or greater now (or if extrapolated to age 60 years) for developing a fatal CVD event; markedly raised levels of single risk factors: cholesterol 8 mmol/l or less (320 mg/dl), low density lipoprotein cholesterol 6 mmol/l or greater (240 mg/dl), blood pressure 180/110 mmHg or higher.

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Editorial
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