The prevention of coronary heart disease would represent a major saving to the NHS. Systematic review of evidence relating to screening for CHD and its prevention suggests that blood cholesterol measurement on its own is a poor predictor of risk. The evidence suggests that lifestyle changes and drug treatments other than cholesterol-lowering drugs are the most cost-effective approach to prevention. Nurses should ensure that all risk factors are assessed and a range of preventive measures considered in situations where CHD is a potential risk.