Structured Graphical Abstract.

GENVASC design and key findings: The GENVASC study was set up to evaluate whether the addition of a polygenic risk score for cardiovascular disease (CVD-PRS) to clinical risk assessment at an NHS Health Check would increase the number of individuals who went to have a major CVD event as being at high risk at their health check. 44 141 individuals free of CVD were recruited at their NHS Health Check and when 195 CVD events had occurred during follow-up, a retrospective case-control study was undertaken to see how many additional individuals would have been identified as high risk at their health check by the addition of the CVD-PRS in the form of an integrated risk tool (IRT) to assessment by the clinical risk score (QRISK2) alone.