Cardiovascular risk reduction - quality prescribing guidance 2026-2029: consultation

2. Executive Summary

Cardiovascular disease (CVD) is largely preventable and many modifiable risk factors increase the likelihood of developing CVD,2 however, many people do not know they are living with CVD risk factors. For example, of the 1.5 million people in Scotland estimated to have high blood pressure, only 860,000 have been diagnosed. Of those diagnosed, only 24% (206,000) are adequately controlled.2

Adopting a healthier lifestyle can reduce an individual's risk of cardiovascular disease. This guide highlights how individuals can be supported in modifying lifestyle risk factors such as diet, healthy weight, alcohol, physical activity, stress and tobacco smoking.

A primary objective of the Scottish Government’s Cardiovascular Risk Factors Programme is to find those living with key modifiable risk factors and to optimise early intervention and care to reduce an individual’s risk of developing CVD. ^[3]

This guide supports the implementation of this risk factor programme by helping healthcare practitioners (HCP) identify and treat five key modifiable risk factors in individuals who do not currently have a diagnosis of CVD. These risk factors are:

• hypertension
• hyperlipidaemia
• obesity
• diabetes
• smoking

This guide promotes evidenced-based identification and management of these risk factors including lifestyle modifications, appropriate monitoring, choice of medication, prescribing considerations and links to more detailed guidance for specialist conditions. It is complementary to SIGN and NICE guidance, providing practical prescribing advice to all healthcare professionals working in this area, supporting good clinical practice for the people of Scotland.

This guide considers using the 7-Steps person-centred medication review before initiating any treatment. This puts the individual at the centre of any conversation about their care and guides decision-making in subsequent steps that consider medication need, effectiveness, and safety before a therapeutic plan and follow-up strategy are agreed upon.