The prevention of cardiovascular disease (CVD) is being moved up a gear with the ambitious and wide-reaching NHS Health Check programme. The agenda for this programme has been clearly laid out for us in the Putting Prevention First best practice guidance that was published in April 2009. The “Cog Man” on the cover highlights the close links between the heart, brain, kidneys and diabetes, explaining the comprehensive nature of vascular risk assessment, and this image is going to be seen regularly on national leaflets and posters promoting the programme. This article provides a practical guideline for the primary care team on implementing the Health Check programme, setting out who we should be checking, what we should be checking and how we should act on what we find.