People living with diabetes and chronic kidney disease (CKD) face a substantially elevated risk of atherosclerotic cardiovascular disease (ASCVD), yet uptake of lipid-lowering therapy (LLT) remains suboptimal across UK primary care.1 In the UK, high-risk primary prevention patients are defined as those with a QRISK3 score ≥10%, indicating a predicted 10-year cardiovascular risk ≥10% and representing the NICE-recommended threshold for offering statin therapy for primary prevention.2 Contemporary clinical guidance strongly supports proactive LLT initiation in diabetes and CKD. However, persistent treatment gaps, especially in rural and socioeconomically deprived areas, limit the effectiveness of ASCVD prevention efforts.3To assess the impact of integrating routine lipid testing into health checks, new-patient reviews, and long-term condition (LTC) reviews to improve LLT uptake among patients with diabetes, CKD, or QRISK ≥10%, and to compare performance against Primary Care Network (PCN) and national averages.This quality-improvement initiative was conducted in a rural, deprived primary care practice. Lipid testing was incorporated into health checks, new-patient assessments, and LTC reviews. Following testing, patients were reviewed by a clinician to optimise LLT, glycaemic control (HbA1c), estimated glomerular filtration rate (eGFR), and albumin–creatinine ratio (ACR) where indicated. Performance was evaluated using CVD PREVENT (June 2025), focusing on patients without diagnosed CVD but with QRISK ≥10%, diabetes, or CKD who received LLT.Practice LLT uptake: 76.62% PCN average: 57.44% National average: 56.98%Our practice substantially exceeded both local and national benchmarks.Integrating routine lipid testing into LTC and new-patient reviews markedly increased LLT uptake within a high-risk population, despite the challenges of a rural, deprived setting. This model demonstrates a practical, scalable approach for family doctors aiming to close prevention gaps in ASCVD. The findings align with recent evidence emphasising the importance of proactive lipid optimisation in diabetes and CKD.1,2,3