Ischemic stroke (IS) is one of the leading causes of mortality worldwide, often viewed through the lens of traditional cardiovascular risk factors such as hypertension, diabetes, smoking, and dyslipidemia. However, the risk-trigger-vulnerability model provides a more comprehensive framework for understanding IS occurrence, distinguishing three key components: (1) risk factors that drive the long-term development of atherosclerosis, (2) trigger factors that precipitate acute coronary events, and (3) tissue vulnerability, which determines the severity of ischemic injury. Recent advances in exposome research offer new insights into how external and internal factors contribute to IS risk. By integrating the exposome into the risk-trigger-vulnerability model, we aim to achieve a more holistic understanding of IS and to develop more precise and personalized prevention strategies. The project is funded by the NWO Gravitation program EXPOSOME-NL (
www.exposome.nl), which focuses on the impact of the exposome on cardiometabolic and cardiovascular health.
In this PhD project, you will examine how long-term exposure to environmental factors influences IS development, considering both external factors (e.g., air pollution, chemicals, and socioeconomic stress) and internal factors (e.g., the microbiome and epigenetics). Furthermore, you will investigate how acute environmental triggers are linked to a rapid increase in IS risk, again considering both external (e.g., air pollution spikes, temperature extremes, and stress events) and internal (e.g., infections and thrombotic activation) immediate trigger factors. In addition, you will relate the exposome to tissue vulnerability to better understand why some people are more susceptible to IS than others.
In this PhD project, you will use various data sources, including nationwide registries from Statistics Netherlands and large-scale longitudinal cohort studies, to investigate IS and ischemia-related outcomes, intermediates, and risk factors. You will enrich these data sources with relevant environmental exposure data (e.g., derived from existing geo-data registers and Street View images). The findings of your studies will be published in scientific journals, and you will have the opportunity to participate in (courses from) the Master’s program in Epidemiology at Utrecht University.
The interviews will take place in the week of 12 January 2026. Questions regarding this vacancy may be sent by e-mail to Dr. Ilonca Vaartjes (
c.h.vaartjes@umcutrecht.nl).