Many clinicians perceive guidelines as tedious and unnecessarily complex, but consider them a necessary “evil” for clinical practice. Others follow guidelines rigourously often at the expense of recognising that guidelines are for populations and not individuals and medicine is not an exact science consisting of binary decions but rather an art, which becomes increasingly relevant at the edges of evidence where the art is in applying what (little) scientific evidence exists. In this regard, on the back of a plethora of robust cardiovascular outcomes trials, global guidelines for cardiovascular disease (CVD) have been quick to construct the evidence base for CVD prevention, and in particular with respect to recommendations for lipid lowering therapy with statins where benefit far outweighs harm. Although the approach in different guidelines may vary, the debate on both sides of the Atlantic has witnessed a convergence where recommendations for the secondary prevention of CVD are concerned.1,2 The same is true for the treatment of primary hypercholesterolaemia including familial hypercholesterolemia (FH) and diabetes mellitus (DM); in the latter two, recommendations are similar but differ in their interpretation of the strength of evidence but are otherwise concordant.