OBJECTIVES: To develop an epidemiological and economic model of cardiovascular disease (CVD, comprising coronary heart disease and stroke) that can be used to predict the future incidence of CVD in a given population (with representative cross-sectional data on cardiovascular risk factors) and undertake cost-effectiveness analyses of primary preventive strategies. METHODS: The CPM is a Markov model comprising four health states: ‘Alive without CVD’, ‘Alive with CVD’, ‘Dead from CVD’ and ‘Dead from non-CVD causes’. Individual subjects’ risks of CVD are derived from Framingham and UKPDS risk equations for non-diabetic and diabetic individuals, respectively. The risks of non-CVD death are drawn from local mortality data. To illustrate the function of the CPM, it was populated with 1335 Australian subjects from the nationally-representative 1999-2000 Australian Diabetes, Obesity and Lifestyle study who were: aged 35-74 years; free of CVD; and met current criteria for reimbursed access to statin treatment. Follow-up was simulated until death or age 75 years. The cost-effectiveness of atorvastatin for the primary prevention of CVD was modelled via decision analysis, using efficacy data from a recent meta-analysis of randomized trials and Australian cost and utility data. A 5% annual discount rate was applied. RESULTS: The CPM predicted that of Australians currently aged 35-74 years who were CVD-free but met criteria for lipid-lowering treatment, 23.3% would develop CVD and 24.3% would be dead by age 75 years without statin treatment. Atorvastatin would reduce these figures to 16.5% and 22.2%, representing numbers needed to treat of 14.7 and 46.2 to prevent CVD and death, respectively. The estimated ICERs were AUD$54,100/YoLS and AUD$35,600/QALY. CONCLUSIONS: The CPM allows for the prediction of future incidences of CVD in a population where representative cross-sectional data on cardiovascular risk factors are available. It can also be applied to cost-effectiveness analyses of primary preventive interventions for that population.