New National Cholesterol Education Program treatment guidelines incorporate a global measure of coronary heart disease (CHD) that alters risk categorization in primary prevention by identifying individuals with CHD risk equivalence on the basis of estimated absolute CHD risk. Increasing recognition of the association of on-treatment non-high-density lipoprotein (HDL) cholesterol levels with risk of CHD events is also reflected in the new guidelines by incorporation of secondary non-HDL cholesterol goals. The increased complexity of the guidelines and the likelihood of more individuals being assigned to higher risk groups with lower low-density lipoprotein (LDL) cholesterol goals is of some concern, because most patients receiving lipid-lowering therapy do not achieve current guideline LDL cholesterol goals. Increased potency of LDL cholesterol-lowering drugs would be of value in enabling more patients to achieve goals.