SummaryRisk estimation with SCORE2 (40 to 69 years) and SCORE2-OP; risk modifiers include a family history of premature cardiovascular disease, lipoprotein(a), coronary artery calcium and psychosocial stress. In apparently healthy people at low-to-moderate risk, lipid-lowering treatment should be considered when LDL cholesterol stays at or above 2.6 mmol/l (100 mg/dl) after lifestyle intervention; a stepwise approach with treatment targets by risk category.

SummaryDefines statin-associated muscle symptoms as symmetric proximal muscle pain, weakness or stiffness beginning within weeks to months of a statin start and improving within weeks of withdrawal; CK is usually normal or mildly raised. Management: withdraw, wait for symptoms to resolve, then rechallenge with the same or a different statin at a lower dose or alternate-day dosing; most patients tolerate a second statin. Non-statin therapy for those who cannot.

SummaryPrediabetes is defined by an HbA1c of 5.7 to 6.4 %, fasting glucose of 100 to 125 mg/dl or a 2-hour glucose of 140 to 199 mg/dl in an oral glucose tolerance test; diabetes from 6.5 % HbA1c, 126 mg/dl fasting or 200 mg/dl at 2 hours. People with prediabetes should be re-tested at least yearly and referred to structured lifestyle programmes.

SummarySteatotic liver disease with at least one cardiometabolic risk factor is MASLD. In primary care, patients with steatosis or metabolic risk should have non-invasive fibrosis assessment with FIB-4: below 1.3 rules out advanced fibrosis with repeat testing in one to three years; 1.3 or above calls for elastography or referral. Treatment is weight reduction, physical activity and control of the metabolic risk factors.