This is a very large and wide-ranging network meta-analysis on primary prevention in cardiovascular disease, which is investigating a wide range of factors thought to be associated with cardiovascular disease morbidity and mortality. It is aiming to assess the factors that have the greatest influence. The results will be of interest to our long-term conditions theme.

Despite recent improvements in the burden of cardiovascular disease (CVD) in the UK, deaths from CVD are relatively high compared with other high-income countries. An estimated 7 million people in the UK are living with CVD, and the healthcare cost is approximately £11 billion annually. In more than 90% of cases, the risk of a first heart attack is thought to be related to potentially modifiable risk factors including smoking, poor diet, high blood cholesterol, high blood pressure, insufficient physical activity, obesity, and excess alcohol consumption. Even though there are a wide variety of possible interventions which are potentially useful for primary prevention of CVD, there is a need amongst decision makers, researchers, policy makers, charities and the general public to know which of these interventions, and which components of these interventions, are the most effective strategies. There is a need to construct a hierarchy of effectiveness of interventions so that primary prevention of CVD can be focused where it is most useful.