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BACKGROUND Clinical guidelines recommend using absolute risk to inform clinical decisions in cardiovascular disease prevention. Absolute risk assessment tools have been disseminated to general practitioners, however current use and knowledge of this is approach among GPs is unknown. METHOD Transcribed audiotapes of focus groups with 36 GPs, analysed for key themes. RESULTS The GPs said absolute cardiovascular risk assessment tools were used largely as an aid to patient education rather than an influence on management, for which the concept was poorly understood. Barriers to their use included poor computer software, inconsistency with regulations over the use of lipid lowering agents, and fears patients would not understand the concepts. DISCUSSION To encourage the implementation of absolute risk tools in cardiovascular disease prevention, and GP education. Attitudes and systematic barriers to their use by GPs need to be addressed.