Purpose: The Laindon model of cardiovascular disease (CVD) risk was developed in order to provide individualised risk estimates incorporating a comprehensive range of risk factors derived from the INTERHEART study. This study estimates the reductions in cardiovascular disease death from lifestyle interventions and statin therapy in those with and without existing CVD or diabetes mellitus (DM), and compares the predicted and actual CVD death rates.

Methods: All subjects between the ages of 35 and 75 years old with complete data sets were extracted. Where no data on risk factors was available, population averages were used. Estimates were made for waist/hip ratio and ApoB/ApoA1 ratios using the body mass index and total cholesterol. The probability of death from CVD at 10 years was calculated for each subject, as was the Anderson Framingham risk for CVD death. The calculations were repeated after applying the following interventions: regular vigorous exercise, a diet rich in fruit and vegetables, diet and exercise combined, elimination of smoking and achieving a 25% reduction in total cholesterol levels in all subjects. The exercise was repeated for all those subjects in the Whickham study between the ages of 40 and 80 over a 5-year time span.

Results: The exercise, dietary, combined exercise and dietary, smoking cessation and cholesterol reduction interventions were predicted to lead to relative risk reductions of 9%, 14%, 23%, 34% and 27% respectively. Of the 1,866 eligable subjects, the predicted rate of CVD death was 4.4% compared to an actual death rate of 5.3% at 10 years. The correlation between the actual CVD and the predicted CVD death rates was 99% for deciles of risk. For the secondary prevention group of 293 subjects, the predicted CVD death rate at 5 years was 7.9% versus an actual CVD death rate of 6.1%.

Conclusions: The predictions of this new model are comparable to the results of randomized controlled trials of statin therapy. There is a slight under-prediction of CVD events in those without CVD and a slight over-prediction of events in those with CVD when applied to this cohort. The correlation between the prediction of the model and the actual CVD death rates is very high. The predicted effect of cholesterol reduction interventions is in keeping with published trials.