Picture this clogged artery: better adherence when patients view their plaques

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Takeaway

  • Viewing images of their atherosclerotic plaques make patients more likely to stick to lifestyle modifications and medication.
  • The tactic is especially effective if findings are contextualized as vascular age.

Why this matters

  • A previous study found that patients do not grasp their cardiovascular risk well when pictograms are used as communication tools.
  • This study used the real images of the individual patient to communicate risk and “vascular age.”

Key results

  • Framingham risk scores (FRS) and European systematic coronary risk evaluation scores (SCORE) differed significantly between intervention and controls:
    • Difference in FRS: 1.07 (95% CI, 0.11-2.03; P=.0017). 
    • Difference in SCORE: 0.16 (95% CI, 0.02-0.30; P=.0010).
  • Decrease in FRS from baseline to 1 year was steeper for intervention group: −0.58 (95% CI, −0.86 to −0.30) vs 0.35 (0.08-0.63) for controls.
  • SCORE increased in both groups, but significantly less in intervention: 0.13 (95% CI, 0.09-0.18) vs 0.27 (0.23-0.30).

Study design

  • Pragmatic, open-label randomized controlled VIPVIZA trial, n=3532 (1783 controls; 1749 intervention), age 40, 50, or 60 years with 1+ risk factors.
  • Imaging of asymptomatic atherosclerotic disease used in intervention.
  • Funding: Västerbotten County Council, others.

Limitations

  • Some differences at baseline between dropouts/remainers in intervention group.