Objective: To examine patients' level of cardiovascular risk in community based clinical practice and assess whether treatment targets as specified in Canadian clinical guidelines (hypertension - 2007, dyslipidemia - 2006, diabetes - 2003, metabolic syndrome - 2006) are met. Methods: A convenience sample of more than 375 general practitioners recruited from across Canada participated between September and December 2007. Case report forms were completed for at least 20 patients during normally scheduled office visits. Current survey results were compared to a similar survey of 450 general practitioners and 17,188 patients conducted in January to April 2006 that used the 2003 dyslipidemia, 2003 diabetes, & 2005 hypertension guideline targets to assess whether treatment targets were met. Results: A total of 1722 patients analyzed to date of which 98% were taking lipid-lowering drugs. Approximately 14,000 patients' data will be available upon study completion. Demographics: 57% male, 40% 65 years or older, 53% 45-64 years. CV risk factors identified: 68% hypertension, 38% diabetes, 26% family history premature CAD, 24% previous history of MI, stroke, or PAD, 25% current or recent smoker, 9% evidence of hyperdyslipidemia. Fifty-four percent of cohort had three or more risk factors. Physician assessed CV risk level: 59% high, 24% moderate, 18% low. Forty percent of patients met the criteria for metabolic syndrome. Patients NOT at guideline targets 2007 survey vs. 2006 survey: hypertension 22% vs. 26%, LDL-C 47% vs. 34%, TC:HDL-C 35% vs. 31%, triglycerides 42% vs. 51%, FBG > 6.2 mmol. 34% vs. 44%, waist circumference 55% vs. 55%. Conclusion: Preliminary aggregate data shows that despite drug treatment many patients are still not at lipid or blood pressure target levels. Community practice physicians in this survey prescribe lipid-lowering drugs to predominantly high (59%) and moderate (24%) CV risk patients.