OBJECTIVES: The degree to which predefined risk factor (RF) changes alter life time benefits and costs in projections with the IMS-CORE-Diabetes-Model (CDM) has been previously reported. The objective of this study was to contrast the relative risk reduction of cardiovascular events by individual RF changes using alternative risk equations (RE), specifically: UKPDS-68 (UK68-RE), UKPDS-82 (UK82-RE) and the  Swedish-National-Diabetes-Registry (SNDR-RE). METHODS: The CDM was applied to estimate annual probabilities for 1st myocardial infarction (MI), 1^st stroke, ischemic heart disease (IHD) and heart failure (HF) for an intermediate risk type 2 diabetes individual (age 55 years, HbA1c 8%, SBP 140 mm-Hg, BMI 30 Kg/m2, TC 250 mg/dl, HDL 50 mg/dl and LDL 170 mg/dl). The relative risk (RR) in association with unit RF changes was determined for HbA1c (-1%), body-mass-index (BMI) (-1 Kg/m), systolic-blood-pressure (SBP) (-10 mmHg), total-cholesterol (TC) (-10 mg/dl), (high-density-lipoprotein (HDL) (+5 mg/dl) and low-density-lipoprotein (LDL) (-10 mg/dl). RESULTS: The RR of CV endpoints associated with risk factor changes for HbA1c, SBP, BMI, TC, HDL and LDL was predicted as follows. MI:  0.89, 0.90, 1.00, 0.98, 1.36, 1.00 (UK-68-RE), 0.93, 0.95, 1.00, 1.00, 1.00, 0.93 (UK82-RE) and 0.92, 0.92, 1.00, 0.99, 1.29, 0.98 (SNDR-RE). Stroke: 0.88, 0.76, 1.00, 0.99, 1.18, 1.00 (UK68-RE), 0.91, 0.84, 1.00, 1.00, 1.00, 0.97 (UK82-RE) and 0.85, 0.94, 1.00, 0.99, 1.18, 1.00 (SNDR). IHD: 0.85, 0.89, 0.94, 1.00, 1.00, 1.00 (UK68-RE), 1.00, 0.94, 1.00, 1.00, 1.21, 0.96 (UK82-RE) and 0.94, 1.00, 0.98, 0.99, 1.29, 1.00 (SNDR-RE). HF: 0.88, 0.91, 1.00, 0.98, 1.48, 1.00 (UK68-RE), 1.00, 1.00, 0.93, 1.00, 1.00, 0.98 (UK82-RE) and 0.83, 0.83, 0.94, 0.99, 1.19, 1.00 (SNDR-RE). CONCLUSIONS: The degree to which RF modification influences CV risk can vary considerably, dependent on RE selected.  The choice of equation within a model may influence the predicted health economic benefit associated with CV risk factor modification.