Lipid management: what are the predictors of benefit?

Clinicians, patients, and healthcare payers are now faced with the reality of the enormous burden of treating hyperlipidaemia and hypertension for pri mary or secondary prevention. On the basis of results of short-term clinica l trials these risk factors will require lifelong therapy. A need therefore exists for disease simulation models that can estimate the long-term benef its of therapy for specific groups of patients. To evaluate fully the benef its of possible treatments, both cerebrovascular events and coronary events must be considered. Recent clinical trial results suggest that, for lipid modification, previous models focusing only on coronary disease may underes timate the impact on stroke. The Cardiovascular Disease Life Expectancy Mod el was developed to estimate the benefits of risk factor modification in th e primary and secondary prevention of cardiovascular disease, including cor onary disease and stroke. It is shown that epidemiological data can be used to forecast the benefits of therapy demonstrated in randomized clinical tr ials.