Diastolic/systolic　blood　pressure　ratio　(D/S)　≥　1.2　is　the　gold　standard　of　enhanced　external　counterpulsation　(EECP)　treatment,　but　it　does　not　show　a　clear　clinical　correspondence　with　the　configuration　of　the　EECP　mode.　As　such,　a　single　target　results　in　different　treatment　effects　in　different　individuals.　The　local　haemodynamic　effect　(wall　shear　stress,　WSS)　of　EECP　on　vascular　endothelial　cells　is　conducive　to　promote　the　growth　of　collateral　circulation　vessels　and　restore　the　blood　supply　distal　to　the　stenosis　lesion.　Considering　the　haemodynamic　effects　of　WSS　on　human　arteries,　this　study　developed　a　real-time　patient-specific　treatment　strategy　of　EECP　for　patients　with　cardio-cerebrovascular　diseases.　Based　on　patient-specific　haemodynamic　data　from　113　individuals,　an　optimization　algorithm　was　developed　to　achieve　the　individualization　of　a　0D　lumped-parameter　model　of　the　human　circulatory　system,　thereby　simulating　the　patient-specific　global　haemodynamic　effects.　0D/3D　coupled　cardio-cerebrovascular　models　of　two　subjects　were　established　to　simulate　the　local　WSS.　We　then　established　statistical　models　to　evaluate　clinically　unmeasurable　WSS　based　on　measurable　global　haemodynamic　indicators.　With　the　aim　of　attaining　appropriate　area-　and　time-averaged　WSS　(ATAWSS,　4–7　Pa),　as　evaluated　by　global　haemodynamic　indicators,　a　closed-loop　feedback　tuning　method　was　developed　to　provide　patient-specific　EECP　treatment　strategies.　Results　showed　that　for　clinical　data　collected　from　113　individuals,　the　individualized　0D　model　can　accurately　simulate　patient-specific　global　haemodynamic　effects　(average　error　＜5%).　Based　on　two　subjects,　the　statistical　models　can　be　used　to　evaluate　local　ATAWSS　(error　＜6%)　for　coronary　arteries　and　for　cerebral　arteries.　An　EECP　mode　planned　by　the　patient-specific　treatment　strategy　can　promote　an　appropriate　ATAWSS　within　a　16　s　calculation　time.　The　real-time　patient-specific　treatment　strategy　of　EECP　is　expected　to　improve　the　long-term　outcome　for　each　patient　and　have　potential　clinical　significance.　©　2024　John　Wiley　&　Sons　Ltd.