Chronic inflammatory rheumatological conditions are associated with an increased burden of cardiovascular disease (CVD). In both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) most excess mortality is cardiovascular. The prevalence of subclinical disease indicates that the atherogenic processes start early in the course of inflammatory disease. Although less data are available regarding the extent of the problem in other inflammatory arthritides or connective tissue diseases, increased CVD risk is also associated with psoriatic arthritis, ankylosing spondylitis, antiphospholipid syndrome and systemic sclerosis. Management of CVD risk in these patient groups is hampered by the complexity of both the underlying disorder and its treatment, and by the lack of clear guidelines for either primary or secondary care teams.