For decades, the incidence and mortality of cardiovascular diseases (CVDs) have declined. More recently, we have seen a halting in these declines, especially at younger ages. It is difficult to predict how these changing trends will impact CVD prevalence. We aimed to predict future prevalence of CVDs in Western Australian adults from 2005-2045 based on current incidence and mortality probabilities, population growth and ageing.Multi-state life table models were developed using 2005-2009 age- and sex-specific incidence and mortality probabilities from the Western Australian Data Linkage System. Prevalence of CVD, coronary heart disease (CHD) and stroke was projected until 2045. Life expectancy and lifetime risk were estimated. We estimate that compared to 2005-2009, we will see 37,235 (CVD), 23,129 (CHD) and 9806 (stroke) more incident cases in 2040-2044. The prevalence of total CVD is predicted to increase from 8.4% in men and 5.1% in women in 2005 to 12.7% and 7.9% respectively in 2045. This seems to be mainly due to population growth and ageing, with some effect of changing incidence and mortality. In Western Australia this represents an additional 106,949 adults living with CVD, of which 65,951 with CHD and 10,928 with stroke, in 2045 compared to 2005.Assuming no major changes in prevention and treatment of CVD, the prevalence will likely increase, with consequent increases in health care need and cost. These findings need to be confirmed by studies in which prevalence is consistently and empirically measured and monitored over time.