The long and winding road to better cardiovascular health: Empowering patients to reduce the risk of adverse cardiovascular outcomes

Atherosclerotic cardiovascular diseases (ASCVD) place a significant burden on both patients and the healthcare system, but are largely preventable through a healthy lifestyle. eHealth solutions can support prevention by assessing risk, providing information, and guiding behavior change. The CARRIER consortium explores how to better integrate eHealth into healthcare, exemplified by the development and evaluation of the digital eCoach. Even for patients with established ASCVD, improving care remains essential. In the Netherlands, over 10,000 cardiac surgeries are performed annually, often accompanied by risks such as last-minute cancellations and complications. This thesis investigates the causes and consequences of such cancellations, showing that medical reasons are linked to poorer long-term outcomes. It also discusses the DCC study, which demonstrated that teleprehabilitation can reduce major adverse cardiovascular events (MACE), although participation was lower among older and high-risk patients. The thesis advocates for personalized prehabilitation programs in cardiac care, tailored to patient profiles, to promote sustainable and future-proof healthcare.