The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: Results from the VIPVIZA randomized clinical trial

Objective: Non-adherence to guidelines and preventive measures is a major challenge, particularly so to obtain long-term adherence to lifestyle changes and recommended medication. The objective was to investigate if pictorial information regarding subclinical carotid atherosclerosis provided to indi...

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Main Authors: Anna Bengtsson, M.D., Margareta Norberg, Nawi Ng, Bo Carlberg, Christer Grönlund, Johan Hultdin, Bernt Lindahl, Bertil Lindahl, Steven Nordin, Emma Nyman, Patrik Wennberg, Per Wester, Ulf Näslund
Format: Article
Language:English
Published: Elsevier 2021-09-01
Series:American Journal of Preventive Cardiology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666667721000532
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spelling doaj-a8fbb885f3834f5f87bdb301efeca7282021-08-24T04:07:54ZengElsevierAmerican Journal of Preventive Cardiology2666-66772021-09-017100199The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: Results from the VIPVIZA randomized clinical trialAnna Bengtsson, M.D.0Margareta Norberg1Nawi Ng2Bo Carlberg3Christer Grönlund4Johan Hultdin5Bernt Lindahl6Bertil Lindahl7Steven Nordin8Emma Nyman9Patrik Wennberg10Per Wester11Ulf Näslund12Department of Public Health and Clinical Medicine, Umeå University, Umeå SE-901 87, Sweden; Department of Epidemiology and Global Health, Umeå University, Umeå, SwedenDepartment of Epidemiology and Global Health, Umeå University, Umeå, SwedenDepartment of Epidemiology and Global Health, Umeå University, Umeå, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenDepartment of Public Health and Clinical Medicine, Umeå University, Umeå SE-901 87, SwedenDepartment of Radiation Sciences, Umeå University, Umeå, SwedenDepartment of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, SwedenDepartment of Public Health and Clinical Medicine, Umeå University, Umeå SE-901 87, SwedenDepartment of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, SwedenDepartment of Psychology, Umeå University, Umeå, SwedenDepartment of Public Health and Clinical Medicine, Umeå University, Umeå SE-901 87, SwedenDepartment of Public Health and Clinical Medicine, Umeå University, Umeå SE-901 87, SwedenDepartment of Public Health and Clinical Medicine, Umeå University, Umeå SE-901 87, SwedenDepartment of Public Health and Clinical Medicine, Umeå University, Umeå SE-901 87, Sweden; Corresponding author.Objective: Non-adherence to guidelines and preventive measures is a major challenge, particularly so to obtain long-term adherence to lifestyle changes and recommended medication. The objective was to investigate if pictorial information regarding subclinical carotid atherosclerosis provided to individuals and physicians gave sustained effects on cardiovascular risk beyond the previously reported effect after 1 year and up to 3 years. Methods: A Prospective Randomized Open Blinded End-point (PROBE) trial. Within a CVD prevention program in Västerbotten County, Sweden, 3532 healthy individuals aged 40, 50 or 60 years were enrolled and 1:1 randomized to intervention (n = 1749; pictorial information with additional prevention materials to participants and physicians) or control group (n = 1783; no pictorial information to participants and physicians). Preventive measures were managed within primary care. Participants were investigated at baseline during 2013–2016 and at follow-up after 1 and 3 years. Results: A beneficial effect on cardiovascular risk was observed at 3-year follow-up; Framingham Risk Score (FRS) was 13.38 for the intervention group and 14.08 for the control group (p = 0.047) and SCORE was 1.69 vs. 1.82 (p = 0.022). The effect observed at 1-year was sustained over 3 years after adjustment for sex and education and more pronounced among participants with a severe atherosclerotic picture at baseline. Conclusions: This study provides evidence of sustained beneficial effects on the adherence to prevention guidelines over 3 years of pictorial information about subclinical carotid atherosclerosis, resulting in lower cardiovascular risk regardless of sex and educational level. Direct visualization of the underlying still subclinical atherosclerotic disease, rather than just indirect information about risk factors and statistical risk of future myocardial infarction, stroke and death, is one way to tackle the problem of non-adherence to prevention of cardiovascular diseases.http://www.sciencedirect.com/science/article/pii/S2666667721000532AtherosclerosisCardiovascular diseaseCarotid ultrasoundPrevention
collection DOAJ
language English
format Article
sources DOAJ
author Anna Bengtsson, M.D.
Margareta Norberg
Nawi Ng
Bo Carlberg
Christer Grönlund
Johan Hultdin
Bernt Lindahl
Bertil Lindahl
Steven Nordin
Emma Nyman
Patrik Wennberg
Per Wester
Ulf Näslund
spellingShingle Anna Bengtsson, M.D.
Margareta Norberg
Nawi Ng
Bo Carlberg
Christer Grönlund
Johan Hultdin
Bernt Lindahl
Bertil Lindahl
Steven Nordin
Emma Nyman
Patrik Wennberg
Per Wester
Ulf Näslund
The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: Results from the VIPVIZA randomized clinical trial
American Journal of Preventive Cardiology
Atherosclerosis
Cardiovascular disease
Carotid ultrasound
Prevention
author_facet Anna Bengtsson, M.D.
Margareta Norberg
Nawi Ng
Bo Carlberg
Christer Grönlund
Johan Hultdin
Bernt Lindahl
Bertil Lindahl
Steven Nordin
Emma Nyman
Patrik Wennberg
Per Wester
Ulf Näslund
author_sort Anna Bengtsson, M.D.
title The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: Results from the VIPVIZA randomized clinical trial
title_short The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: Results from the VIPVIZA randomized clinical trial
title_full The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: Results from the VIPVIZA randomized clinical trial
title_fullStr The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: Results from the VIPVIZA randomized clinical trial
title_full_unstemmed The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: Results from the VIPVIZA randomized clinical trial
title_sort beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: results from the vipviza randomized clinical trial
publisher Elsevier
series American Journal of Preventive Cardiology
issn 2666-6677
publishDate 2021-09-01
description Objective: Non-adherence to guidelines and preventive measures is a major challenge, particularly so to obtain long-term adherence to lifestyle changes and recommended medication. The objective was to investigate if pictorial information regarding subclinical carotid atherosclerosis provided to individuals and physicians gave sustained effects on cardiovascular risk beyond the previously reported effect after 1 year and up to 3 years. Methods: A Prospective Randomized Open Blinded End-point (PROBE) trial. Within a CVD prevention program in Västerbotten County, Sweden, 3532 healthy individuals aged 40, 50 or 60 years were enrolled and 1:1 randomized to intervention (n = 1749; pictorial information with additional prevention materials to participants and physicians) or control group (n = 1783; no pictorial information to participants and physicians). Preventive measures were managed within primary care. Participants were investigated at baseline during 2013–2016 and at follow-up after 1 and 3 years. Results: A beneficial effect on cardiovascular risk was observed at 3-year follow-up; Framingham Risk Score (FRS) was 13.38 for the intervention group and 14.08 for the control group (p = 0.047) and SCORE was 1.69 vs. 1.82 (p = 0.022). The effect observed at 1-year was sustained over 3 years after adjustment for sex and education and more pronounced among participants with a severe atherosclerotic picture at baseline. Conclusions: This study provides evidence of sustained beneficial effects on the adherence to prevention guidelines over 3 years of pictorial information about subclinical carotid atherosclerosis, resulting in lower cardiovascular risk regardless of sex and educational level. Direct visualization of the underlying still subclinical atherosclerotic disease, rather than just indirect information about risk factors and statistical risk of future myocardial infarction, stroke and death, is one way to tackle the problem of non-adherence to prevention of cardiovascular diseases.
topic Atherosclerosis
Cardiovascular disease
Carotid ultrasound
Prevention
url http://www.sciencedirect.com/science/article/pii/S2666667721000532
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