Agreement between the European societies of atherosclerosis, cardiology, and hypertension on how to prevent coronary heart disease in clinical practice resulted in recommendations published in 1994. They were recently revised as a result of new evidence, particularly from clinical trials, of lowering of serum cholesterol.1Underlying the concept of joint European recommendations has been the explicitly stated premise that they should be adapted to national conditions and resources.

With remarkable alacrity this has now been accomplished in the UK with the publication of recommendations from the British Cardiac Society, the British Hyperlipidaemia Association, and the British Hypertension Society (endorsed by the British Diabetic Association).2 As indicated in the title, the joint British recommendations on prevention of coronary heart disease in clinical practice closely mirror the European guidelines. One example is the simple recommendation that total cholesterol < 5 mmol/l (190 mg/dl) and low density lipoprotein (LDL) cholesterol < 3 mmol/l (115 mg/dl) should be goals of treatment in both primary and secondary prevention.

The differences between the European and …