Cardiovascular Disease and the Use of Swedish Health Care Registries and Electronic Medical Data From Primary Care: Disease Reality, Risk Factors, Comparative Effectiveness and Outcomes

Abstract

Data from Swedish health care registries, being nationwide and linkable with other registers by using personal identification number, provides an excellent source for disease insights from various aspects. Paper I showed that among peripheral artery disease (PAD) patients the presence of additional risk factors other than age was the main driver for both CV-related and non-CV-related costs. Although the PAD population has a well-recognized high-CV risk, the major proportion of hospitalization costs for PAD patients are not related to CV disease. Furthermore, the combination of Swedish health care register data and data extracted from primary care medical records can be used to study risk predictors and outcomes. In paper II it was shown that two-thirds of statin-naïve patients initiating statin treatment had a change in their HDL-C level. A paradoxical decrease in HDL-C of (0.1 mmol/L) was associated with a 56% increase in major adverse cardiovascular events compared with unchanged HDL-C levels. No association between increased HDL-C levels and risk of major adverse cardiovascular events was observed. While in paper III was shown that in the management of hypertension, candesartan treatment compared with enalapril treatment was associated with a risk reduction of new-onset diabetes, while no difference was observed between the two treatments in prevention of cardiovascular outcomes.