Methodological and Epidemiological Studies of Cardiovascular Structure and Function

Three methodological aspects were the thematic axis of this thesis:

1. The analysis of repeated measures of variables such as electrocardiogram in neonates, changes in echocardiographic variables that evaluate left ventricular diastolic function in adults of the Rotterdam Study and dynamic changes in systolic blood pressure over time and its association with clinical outcomes in the participants of the Systolic blood PRessure INTervention Trial (SPRINT trial).

2. The application of advanced statistical methods for the analysis of causal inference such as:
   i) Propensity score matching, applied in the selection of the best control group in quasi-experiments involving vascular interventions in octogenarians diagnosed with abdominal aortic aneurysm and in patients with coronary heart disease undergoing Fractional Flow Reserve (FFR) to guide the best therapy and,
   ii) Mendelian randomization analysis to assess the causal relationship between serum levels of dehydroepiandrostenedione sulfate (DHEAs) and N-terminal type B natriuretic pro-peptide (NT-pro-BNP), hormones directly related to changes in the structure and function of the cardiovascular system associated with heart failure and aging.

3. Finally, the dynamics changes in thoracic aortic diameters and their associated risk factors, the implication of these changes in the development of clinical events and, the evaluation of the hypothesis that atherosclerosis is a systemic condition affecting different vascular beds in a similar manner was explored.