Cardiovascular diseases (CVDs) have become one of the leading causes of death globally and in China. With changes in lifestyle and an aging population, the prevalence of CVDs continues to rise, posing significant challenges to public health. Primary healthcare plays an important role in the prevention and the management of CVDs, with risk assessment and risk communication being the core components. Grassroots general practitioners can dynamically track patient risks through long-term doctor-patient relationships by conducting comprehensive assessments of the patient's health status and utilizing effective risk assessment tools such as the China PAR model and Framingham risk score to achieve personalized risk assessment, thanks to their service characteristics of "first visit, continuity, and accessibility". This grassroots risk communication mechanism is in line with the "patient-centered" prevention strategy advocated by international guidelines such as the American Heart Association (AHA) and the European Society of Cardiology (ESC) . Through risk visualization, it helps change health behaviors and improve medication adherence. However, grassroots risk communication still faces multiple challenges. This article explores the current status, application, and challenges faced by risk assessment and communication strategies for grassroots CVDs, and proposes suggestions for improving the communication skills and implementation strategies of grassroots general practitioners. The aim is to refine risk communication strategies to enhance the prevention and control effectiveness of CVDs and ultimately improve the health management level of grassroots patients.