The objectives of the study were to identify the level of general prac
titioner (GP) involvement in activities aimed at coronary heart diseas
e prevention and to explain variations in involvement. These questions
were explored through a postal survey of a random sample (n = 1696) o
f GPs in England of whom 64% completed questionnaires. Ninety-four per
cent of GPs reported that they were involved in risk factor assessmen
t in the consultation although these assessments most commonly involve
d blood pressure testing and identification of smoking. Ninety-one per
cent of practices were reported by the GP to have a lifestyle risk as
sessment clinic where there was more evidence of systematic risk asses
sment. These clinics were usually run by a practice nurse as were life
style risk factor management clinics although GPs were more involved i
n hypertension and cholesterol clinics. Positive attitudes to preventi
on and training in health promotion were associated with higher GP inv
olvement, and higher practice involvement was associated primarily wit
h the number of practice nurses employed. The implication of these fin
dings are discussed.