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VIPVIZA: Pictorial representations of atherosclerosis severity reduce CVD risk
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Patients who were shown pictorial representations of their atherosclerosis severity by their doctors had a decreased risk for CVD 1 year later, according to a study published in The Lancet.
“Our study supports further attempts to solve the major problem of prevention failure because of low adherence, despite effective, cost-effective and evidence-based medications and methods for a healthier lifestyle,” Ulf Näslund, MD, professor and chief physician in the department of public health and clinical medicine at Umeå University in Sweden, and colleagues wrote.
Patients with CV risk
Researchers analyzed data from 3,532 patients who met one of the following criteria:
- aged 40 years with a first-degree relative with a history of CVD when they were younger than 60 years;
- aged 50 years with at least one CVD risk factor; or
- aged 60 years.
Researchers assessed CVD risk factors at baseline for all patients, in addition to blood samples and information collected from a questionnaire on medication, health, education, lifestyle habits and family history of CVD and diabetes. Patients also underwent carotid ultrasound examinations. At 1 year, clinical CVD risk factors were assessed and a questionnaire on pharmacological treatments and lifestyle habits was readministered.
Patients were assigned to the intervention (n = 1,749) or control (n = 1,783) group. Those in the intervention group along with their primary care physician were given a pictorial presentation of carotid ultrasound results, which gauged atherosclerosis presentation and compared the patient’s biological age with their chronological age. Patients received a follow-up phone call after 2 to 4 weeks to provide additional information. After 6 months, patients were given the same pictorial information.
Patients in the control group were not given pictorial information, although both groups received normal care throughout the duration of the study.
The primary outcomes were changes in Framingham risk score and European systematic coronary risk evaluation from baseline to 1 year.
Among the cohort, 3,175 completed 1-year follow up.
Score changes at 1 year
At 1 year, Framingham risk scores differed between the intervention (12.24) and control groups (13.31; P = .0017). This also occurred with the European systematic coronary risk evaluation (1.42 for intervention group vs. 1.58 for control group; P = .001).
There were small changes that were statistically significant regarding the Framingham risk scores in patients assigned the intervention (–0.58; relative change = –5%; 95% CI, –0.86 to –0.3) and those assigned the control (0.35; relative change = 3%; 95% CI, 0.08-0.63).
Slight increases in the European systematic coronary risk evaluation were seen in the intervention (0.13; 95% CI, 0.09-0.18) and control (0.27; 95% CI, 0.23-0.3) groups.
“Whether the effects, mediated through relevant pharmacological treatment and healthy lifestyle habits, are sustainable and lead to reduction of cardiovascular disease events will be determined in future long-term follow-up studies,” Näslund and colleagues wrote. “If clinical event rates are reduced in the follow-up studies, this simple intervention could easily be applied in general practice in other similar settings.”
In a related editorial accompanying the study, Richard Kones, MD, medical director of the Cardiometabolic Research Institute in Houston, and colleagues wrote: “Generalizability to different populations remains a concern, especially to those with adverse social determinants of health. If a family with exceptionally low income does not have sufficient resources for transportation or has limited access to medications because of cost or unavailability, these limitations will prevent expression of improved motivation. In the USA, prices of medications exceed those in Sweden and elsewhere, and health disparities are greater than in Sweden.” – by Darlene Dobkowski
Disclosures: The authors of the study and the editorial report no relevant financial disclosures.
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