DNA will be isolated from buccal cells contained in a sample of saliva sent, after informed consent to the StoreGene laboratory, currently hosted by the Centre for Cardiovascular Genetics at UCL. Samples will be identified only by a unique study number and barcode. The Genetic Profile will be determined in a single run using a commercial method being currently developed in collaboration with a company called Randox has a very high accuracy and is rapid and robust. For each individual the combined Genetic Profile Test score is calculated, and will be classified as being of “average genetic risk”, “low genetic risk” or “high genetic risk” will be sent to the referring Consultant who will link the ID code with the individuals name and inform the patient of the result at the next clinic appointment. This information will be used, in combination with the risk score estimated from the individual’s classical risk factors using the Framingham algorithm to give CHD-risk reduction advice, which will include lifestyle and therapeutic options. The National Institute for Clinical Excellence (NICE), which sets standards of clinical treatment in the UK, recommends that subjects with a ten year risk of CVD of >20% would qualify for statin therapy aiming to reduce cholesterol to 4.0mmol/l under Joint British Society Guidelines (JBS2).  Thus all subjects with >20% Framingham risk will be offered statin or other therapy depending on their risk factors (eg blood pressure). Individuals with a low 10 year risk (<10%) can be reassured and encouraged to maintain a healthy life style. The Genetic Profile Test is of clinical value in subjects at intermediate risk. We estimate based on a large study of healthy middle-aged UK men followed now for 15 years for the development of heart disease, that of the men at intermediate “Framingham” risk (10 year risk of 10%- 20%), 7-10% would move into the >20% risk category and qualify for statin treatment. How the test will be administered? © StoreGene, 2011