 Estimating the risk of future cardiovascular events such as death, stroke and myocardial infarction using traditional risk factors such as age, gender, smoking, diabetes, hyperlipidaemia and hypertension is well accepted in patients with and without existing cardiovascular disease. These estimates are based on a number of robust observational studies, including the original Framingham study. While these methods apply reasonably well on a population level their application to the individual patients is not always straightforward. In addition, risk charts, such as those published by the Joint British Societies and American Heart Association, may underestimate risk in certain groups, notably diabetics and patients of Indo-Asian background, whilst overestimating risk in others by as much as 50 in some studies. 