“Effective stroke prevention should be tailored to include the individual’s clinical features, lifestyle, and environment. This is also known as precision prevention. An important example that illustrates the need for precision prevention is the existence of differences between women and men in the onset of stroke. In practice, however, only traditional risk factors, such as smoking and high blood pressure, are taken into account to predict the risk of a stroke. Women-specific risk factors are therefore not yet taken into account. As a result, women with an increased risk of stroke may be missed, which means that preventive treatments are not started in time,” says Van Os. “In this thesis, I have attempted to lay the groundwork for precision stroke prevention in women.”
Develop forecasting models
Van Os has divided his thesis into two parts. Part I discusses the pathophysiology underlying female-specific stroke risk factors and gender differences in the clinical presentation of stroke. “In part II, I describe how health data from the electronic health record can be used to develop predictive models for stroke risk, specifically for women under 50.”
Relationship migraine and cerebral infarction
One of the striking results of his research is that Van Os believes that the mechanisms underlying the relationship between female-specific risk factors and stroke, in particular the relationship between migraine and cerebral infarction, seem to play a significant role, especially in the fertile phase of life. “In addition”, says Van Os, “woman-specific risk factors seem to be of added value in the predictions. However, there is still a long way to go to actually implement these models in practice, such as testing these models on new datasets and complying with current laws and regulations for safe application.”
Implement smart systems
Ultimately, Van Os hopes that his research can form a basis for the precision prevention of stroke in women. Van Os: “In close collaboration with the general practitioner, the practice nurse, the patient and companies that develop software, we hope to develop, further develop and implement smart systems that can bring more information about the risk of stroke in women into the consultation room. . This can help to start communicating about this risk and what can be done about it in good time. Like a healthier lifestyle, for example.”
Hine (Hendrikus) van Os will defend his PhD on 7 March from 4:15 – 5:00 pm with his thesis ‘Hacking stroke in women – Towards aetiology-driven precision prevention’. The live stream can be followed via this link.