University affiliation
Lund University
Main supervisor
Veronica Milos Nymberg, associate professor
PhD project participating in the National Research School in General Medicine.
The heart can beat billions of times throughout a lifetime, pumping oxygen-rich blood throughout the body. To aid the heart in its lifelong mission, healthy lifestyle habits are essential and in case of cardiovascular disease medication may also be necessary. However, effectuating sustainable lifestyle changes is challenging and there may be a lack of harmony between treatment guidelines and prescribed medications. To promote tomorrow’s heart health care, I explore the gap between knowledge and action in my doctoral project, as well as examine possible ways to bridge it.
High blood pressure often exists without symptoms but can contribute to cardiovascular disease and premature death. To preserve good health and reduce future suffering, it’s therefore important for individuals with high blood pressure to adopt a healthy lifestyle and adhere to prescribed medications. However, research has repeatedly shown that individuals with high blood pressure may find it challenging to adhere to medical advice and to make lifestyle changes.
Inadequately treated high blood pressure is a common cause of heart failure, a syndrome characterized by leg swelling, shortness of breath and fatigue. Heart failure can result in both reduced quality of life and premature death. Registry studies have shown that individuals with heart failure may constitute an undertreated group and at the same time there are evidence-based treatment methods with proven efficacy.
To contribute to increased knowledge about how the primary care’s efforts in preventive measures, investigation and treatment of cardiovascular disease can contribute to preserved health and reduced risk of future illness.
The overarching theme of the research plan is heart health from a primary care perspective. This means that the project spans from preventive measures for high blood pressure to the investigation and treatment of established cardiovascular disease, with increased participation, health promotion and collaboration between primary care and secondary care being important aspects.
The first two studies investigate whether ECG-based heart age can serve as a tool in patient consultation to prevent future cardiovascular disease. The first study is a randomized controlled study examining how individuals with high blood pressure act on receiving information about their future risk of cardiovascular disease in form of a heart age calculated from ECG-changes. The second study is a qualitative study exploring individual’s experience of receiving information about their ECG-based heart age.
The two concluding studies are based on the Heart Failure in Southern Sweden (HISS). HISS is a cohort study that has included approximately 590 patients with heart failure from several primary care centers in Skåne. The participating primary care centers are engaged in a mutual learning conference where the primary care physicians and heart failure nurses meet with an invited cardiologist to discuss heart failure treatment. The third study is a cross sectional study focusing on how the investigation of heart failure is conducted in primary care and how investigation findings correlate with different treatment regimens. The fourth study examines the effects of an increased collaboration between primary care and secondary care in terms of choice of treatment regimen for patients with heart failure.
Cardiovascular disease is the most prevalent public health issue in Sweden, where the condition can have significant consequences for the individual, including an increased need for healthcare services and impaired work capacity. This can result in a substantial impact on societal functions and the economy. There are effective preventive measures to avoid future illness as well as evidence-based treatments that can reduce the effects of developing cardiovascular disease. It’s therefore important to increase awareness of how primary care can support both individuals at risk of developing cardiovascular disease and those who have already been affected.
Lund University
Veronica Milos Nymberg, associate professor