Cardiovascular disease burden and cost-effectiveness of cardiovascular risk screening in Sri Lanka

The risk of dying prematurely from the four most common non-communicable diseases—cardiovascular disease, respiratory disease, diabetes and cancer—is 1.5 times higher in low- and middle-income countries than in high-income countries. While high-income countries have seen rapid declines in the burden of cardiovascular disease in the past two decades, low- and middle-income countries lag behind.
Using nationally representative data from the Sri Lanka Health and Ageing Study (SLHAS), this thesis first examines the burden of cardiovascular disease and its risk factors—hypertension, diabetes, and hypercholesterolemia—on health and healthcare use in Sri Lanka, including when these conditions are undiagnosed. It then looks at how to optimise the country’s existing cardiovascular risk screening program by evaluating modifications that enhance cost-effectiveness while maintaining equitable outcomes. The thesis also examines the impact of opportunistic screening for these conditions within routine healthcare encounters.
Using epidemiological analysis and economic modelling, these studies suggest ways to optimize screening and treatment for cardiovascular disease and its associated conditions to maximize impact while efficiently and equitably allocating scarce healthcare resources. The results offer valuable evidence for policymakers to refine national screening programs, ensuring that interventions maximise health benefits and reduce disparities in access to CVD prevention in Sri Lanka.