Cardiovascular disease (CVD) is the world’s leading cause of death and a major source of preventable premature mortality and economic loss, particularly in low- and middle-income countries. Yet much of this burden is linked to modifiable risk factors and conditions, including hypertension, that can be prevented or managed through actions taken outside traditional health facilities.
Part of UNU-CPR’s Self-Care Pathways to Financing Health and Development series, this companion paper examines how cardiovascular self-care can improve health outcomes while reducing health-system pressures, strengthening household financial protection and supporting wider economic returns. It considers interventions including home monitoring, medication adherence and health-promoting behaviours, alongside the health-system support needed to make them effective and equitable.
Building on the series’ overarching framework, the paper traces three interconnected pathways through which cardiovascular self-care can generate returns: reducing health-system costs through earlier detection, prevention and routine management; strengthening household financial security by reducing out-of-pocket expenditure and catastrophic health costs; and supporting longer-term economic growth by preventing premature death and disability and protecting productivity and economic participation.
Examples from South Africa, India, Colombia and Chile demonstrate how these approaches can be integrated into existing health infrastructure and publicly financed services. They highlight opportunities to extend hypertension screening and treatment through community health workers, task-sharing, decentralized care, reliable access to medicines and support for self-monitoring.
The paper also emphasizes that the benefits of self-care are not automatic. Effective cardiovascular self-care depends on reliable medicines, referral pathways and primary-care capacity, as well as financing and regulation that prevent costs and responsibilities simply being transferred to individuals. Equity must be built into programme design, accounting for differences in income, gender, disability, geography, literacy and connectivity.
Together with the series’ main paper and companion paper on maternal health, the analysis makes the case for moving self-care from the margins of health policy towards systematic integration within universal health coverage and health and development financing strategies.
