You've heard the story before... "I've installed the HD textures for Skyrim and now my game is choppy.."
Fair enough right?
Disabled a bunch of texture mods, some other mods, and really it comes down to VRAM. This was my first experience of hitting the VRAM barrier. After finally coming to terms with that I did research to figure out how to alleviate this without disabling the REALLY nice textures.
Quick history is that I've never had this problem and I try to keep my textures at the 1024 level. Skyrim 2K HD is out of the running. I'm cool with this. I'm not seeing a lot of choppiness, just places like the famous top of the steps of Dragonreach looking out on the town panning becomes kind-of a slide show. Some hitching running full bore on my horse outside. Etc. The places with most of the textures in one view. I get it. Problem is my game used to run fancy smooth and I'm kind-of nit picky as my machine USED to be pretty awesome. Regardless I'm gonna update the video card for one with more ram fairly soon but I'm looking at being poor a little while longer so...
What specific settings alleviate the most VRAM? A definitive guide I believe does not exist for this. Everything I read is based on FPS. Although since the packs release there have been some great suggestions. I'm putting this here to help all the downtrodden in the help to alleviate VRAM before having to >gasp< remove the HD textures and to serve as an additional guide to tweaking Skyrim. Hopefully to help me out as well.
My main operating system is on an SSD with Windows 7 64x with 8 Gigs of RAM. System is fully updated and heavily maintained to be a killing machine. Everything is defragged. (Except the SSD)

Video Hardware is 2 x 1GB Nvidia GTX295 in SLI (Quad Core 3.15 Gz Intel)
Okay so this is what I have assembled so far - what I'm going to try when I get outta work tonight.
First - Delete skyrim.ini and skyrimpref.ini from your \documents\games\skryim folder. This essentially will reset everything. I'll keep backup copies of what I have to tweak. to compare with the newly created and fresh skyrim.ini and skyrimpref.ini
Second - Disable Full Screen AA. I have mine set at 2x with a 16x AF setting through Nvidia. Going to drop the AA completely and moves to FXAA plus reduce AF to 8x.
Third - and this is where you come in - what are the settings that most effect VRAM in Skyrim? Object distance? Grass? What is the most bang for the buck when it comes to VRAM?
Also note that I'm assuming (and I could be very very wrong here) that Shadows are heavily CPU dependent and don't rely on VRAM correct? My system runs 60FPS as long as my VRAM isn't getting destroyed. What I'm saying is I don't need to mess with the shadows right?
And finally if you fine people can't fill in the blanks there is a utility on the Nexus that will log Skyrim for VRAM usage so if I really wanted to spend A LOT of time doing this I could go there to finally figure it out and report back. I'm really hoping someone already has the brain cell retention to have done this already.

Long winded I know but there ya go! I'll report my findings here later. Thanks!