Objective:  To estimate 10-year cardiovascular disease (CVD) risk using the risk equation and risk categories of the Joint British Societies’ Guidelines on Prevention of Cardiovascular Disease in Clinical Practice (2005).

Methods:  A cross-sectional CVD screening programme was conducted in 35 towns in Great Britain. In total, 27,776 men and 43,261 women aged at least 18 years were screened. The estimated 10-year risk of CVD was calculated and directly standardised to the population of Great Britain.

Results:  The age standardised combined prevalence of known CVD, diabetes, lipid-lowering or antihypertensive drug therapy, which preclude multifactorial risk assessment, was 18.0% for men and 18.1% for women. CVD risk was calculated for 56,863 individuals, and the age-standardised prevalence of an estimated 10-year CVD risk < 10% was 42.7% (95% CI: 42.2–43.1) for men and 60.4% (95% CI: 60.1–60.7) for women; 10% to < 20% was 19.6% (19.1–20.6) and 15.6% (15.2–15.9); and ≥ 20% was 19.6% (19.1–20.0) and 6.0% (5.8–6.2) respectively. After aggregating known CVD, diabetes, antihypertensive or lipid-lowering drug therapy, or an estimated CVD risk of ≥ 20%, the combined standardised prevalence of high CVD risk for individuals aged 50 years or more was 74.1% (73.5–74.8) for men (n = 14,787) and 45.5% (44.8–46.2) for women (n = 24,400).

Conclusions:  Using current risk thresholds, there is a substantial unmet need for primary prevention of CVD, particularly among middle-aged men. The results emphasise the scale of intervention that a strategy of individual risk assessment and pharmacological intervention requires.