Heart disease in women and men: insights from Big Data

In this thesis, occurrence and detection of cardiovascular diseases and risk factors were explored and associated sex differences were investigated.
It was shown that primary prevention and detection of cardiovascular disease is suboptimal is in the northern part of the Netherlands. The number of individuals with cardiovascular risk factors and cardiovascular disease is high and cardiovascular risk management is being underutilized. It was demonstrated that an increase in awareness of individuals and general practitioners on risk profiles might expand the amount of preventive medication.

Interestingly, it was demonstrated that women are at higher risk for not detecting cardiovascular disease compared to men. In women, the proportion of MIs that remain unrecognized is higher compared to men in the northern part of the Netherlands. Also, electrocardiographic criteria for detecting left ventricular hypertrophy show lower accuracy in women. New sex-specific electrocardiogram criteria for detecting left ventricular hypertrophy criteria were suggested, with similar accuracy in men and women.

Lastly, (novel) risk factors of cardiovascular disease were explored. Evidence for a causal relationship between blood pressure and left ventricular hypertrophy was established, but not between resting heart rate and coronary artery disease and myocardial infarction.