Individuals with arterial vascular diseases (AVDs) are at significantly increased risk of heart attack, stroke, and death. Early diagnosis and appropriate management of AVDs may help prevent these life-threatening events and associated costs. There is substantial evidence that the majority of AVDs remain under detected and under treated in routine clinical practice. This research synthesized clinical and economic evidence in support of targeted screening for detection of AVDs and personalized, stratified treatment based on the patient risk profile. Given the cost-effectiveness results of AVDs screening and risk based customized treatment findings presented in this dissertation, current screening and treatment guidelines need to be reconsidered.