Improving cardiovascular risk assessment in primary care

Boer, A.W. de (2018)

Doctoral Thesis

The main objective of this thesis was to improve cardiovascular risk assessment in primary care. Chapter 2 provides evidence that coded diagnosis from general practice electronic health records are a feasible and valid alternative to self-report to define diabetes cases in epidemiological studies. Based on the results of focus group discussions with research participants confronted with an incidental finding, as described in Chapter 3, we concluded that a detailed study protocol is needed on the disclosure of incidental findings before recruitment of participants. We gave several recommendations to improve the disclosure of incidental findings. Our findings in Chapter 4 suggest that it is important to inform the general practitioner and the research participants about the individual cardiovascular test results. Only participants with an estimated intermediate of high cardiovascular risk should receive a recommendation to consult their general practitioner. In Chapter 5, we concluded that inviting patients with overweight or obesity for cardiovascular risk assessment can help to identify a substantial additional group of patients at increased cardiovascular risk. In Chapter 6, we did not find evidence that cardiovascular risk assessment can be improved when non-invasive markers of hepatic steatosis are added to an established risk estimation system.

• Prevention
• Cardiovascular diseases
• General practice
• Risk factors
• Cohort studies

• All authors: Boer, A.W. de
• Supervisor: Numans, M.E.
• Co-supervisor: Blom, J.W.; Mutsert, R. de
• Committee: Bom, J.G. van der; Heijer, M. den; Weert, H.C.P.M. van; Hollander, M.
• Qualification: Doctor (dr.)
• Awarding Institution: Medicine / Leiden University Medical Center (LUMC), Leiden University
• Date: 2018-03-06
• ISBN (print): 9789462338678