Abstract
BACKGROUND: Aotearoa New Zealand is among the few countries that routinely collect and utilize individual-level, linked electronic health data for cardiovascular research. This comprehensive health data infrastructure supports large-scale registry-based research, including observational studies and pragmatic randomized clinical trials embedded within registries. OBJECTIVE: In this review, we evaluate the scope and utility of New Zealand's electronic health data for cardiovascular research. First, we present an overview of the demographics and epidemiological trends in cardiovascular disease within New Zealand. Second, we describe the primary health data sources used in cardiovascular research and assess their coverage, content, linkage capabilities, and data quality. Finally, we explore the future potential of these data assets to advance cardiovascular research, highlighting exemplar applications and key ethical, legal, and infrastructural considerations. We also compare New Zealand's electronic health data with those of the Nordic countries and the United Kingdom, whose well-established registry systems offer valuable insights for informing New Zealand's approach to registry-based research and suggest opportunities for future cross-country collaborative research. RESULTS: Cardiovascular research in New Zealand is informed by a combination of nationwide administrative registries, clinical quality registries, and researcher-initiated registries, all linkable via a unique health identifier. These data sources provide comprehensive information on healthcare services, clinical practice, and broader social determinants such as socioeconomic conditions. While data quality and completeness vary, several collections, particularly large researcher-initiated cohorts, demonstrate high utility for observational studies, registry-enabled clinical trials, risk prediction modelling, and quality improvement initiatives. Additionally, New Zealand's health data infrastructure demonstrates the potential for international cardiovascular research. CONCLUSION: New Zealand's electronic health data represent a valuable resource for cardiovascular research, with applicability to both observational studies and clinical trials.