OBJECTIVES: Scottish Intercollegiate Guidelines Network (SIGN) guidelines advise that at risk patients should be treated to a total cholesterol (TC) target of <5mmol/L. Recent Joint British Societies Guidelines (JBS2, 2005) recommend patients be treated to a lower TC target of <4mmol/L. An audit was conducted to determine the effect of the new guidelines on the proportion of patients achieving target cholesterol levels with rosuvastatin. METHODS: General Practice records were searched to identify patients who had been prescribed rosuvastatin 10mg and the following data recorded: previous statin therapy, last cholesterol result on that statin and first cholesterol test on rosuvastatin 10mg. RESULTS: A total of 508 patients who had previously been prescribed rosuvastatin 10mg were identified. Of these 376 had both a pre- and post-rosuvastatin treatment total cholesterol test. The majority of patients were statin-naive (n=253), the others had previously been prescribed atorvastatin, mean dose 14mg (n=102), simvastatin mean dose 19mg (n=22) or pravastatin mean dose 15mg (n=2). Prior to treatment with rosuvastatin 13% (49/376) had a TC <5mmol/L, increasing to 81% (303/376) after treatment with rosuvastatin 10mg. In previously statin naïve patients 82% (208/253) achieved TC<5mmol/L on rosuvastatin compared to 77% (95/123) in patients who had previously been treated with another statin. On average patients experienced a 1.6mmol/L (27%) reduction in TC (32% in statin naïve, 16% where statin changed). Improvements were also seen against JBS2 targets; patients with TC<4mmol/L improved from 3% (11/376) prior to rosuvastatin to 35% (131/376) on rosuvastatin 10mg (37% in statin naïve, 30% where statin changed). CONCLUSIONS: Rosuvastatin 10mg was effective in the reduction of TC in a Scottish General Practice. The majority of patients were able to achieve SIGN targets and many patients also achieved the lower JBS2 targets.