The GPs described their risk assessment and patients’ risk perception as more accurate with the VIPVIZA intervention. The effect was partly mediated by differences in intake of lipid-lowering medication and partly by lifestyle behaviour. The results up to three years showed a VIPVIZA intervention effect, with lower and sustained CVD risk in the intervention as compared to the control group. Clinical risk factors explained more of the variation in a combined ultrasound measurement than single measurements. The plaque prevalence was 44.7% in this population. The interviews were analyzed by qualitative content analysis. Individual interviews were conducted with 15 GPs to explore how a pictorial representation of subclinical atherosclerosis affects physicians in their perception and communication of CVD risk. In addition to conventional risk factor-based risk evaluation, the impact of the VIPVIZA intervention on CVD risk, traditional risk factors and pharmacological treatment was evaluated after 1 and 3 years. The association between clinical risk factors and measures of subclinical atherosclerosis was investigated. The prevalence of subclinical atherosclerotic disease was assessed as intima media thickness and presence of plaque. Preventive measures were managed within primary health care.Īt baseline, clinical risk factors were measured and carotid ultrasound examination was performed. Middle-aged individuals at low/intermediate CVD risk were enrolled to VIPVIZA and randomized 1:1 to an intervention (n=1749) or control group (n=1783 who received no pictorial or other information). VIPVIZA is a Prospective Randomized Open Blinded End-point (PROBE) trial nested within VIP, a CVD prevention program in primary health care in Västerbotten county, Sweden. This includes the provision of pictorial information of subclinical atherosclerosis to participants and their general practitioners (GPs), follow-up phone call, and written information to the participant. The overall aim was improved cardiovascular disease (CVD) prevention through the VIPVIZA intervention. Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems Identifiers URN: urn:nbn:se:umu:diva-186686 DOI: 10.1016/j.ajpc.2021.100199 OAI: oai::umu-186686 DiVA, id: diva2:1585776Ģ021 (English) Doctoral thesis, comprehensive summary (Other academic) Alternative title Visualisering av subklinisk ateroskleros : en metod för att minska risken för hjärt-kärlsjukdom 7, article id 100199Ītherosclerosis, Cardiovascular disease, Carotid ultrasound, Prevention National Category Place, publisher, year, edition, pagesElsevier, 2021. 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. 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.Ĭonclusions: 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. 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. Participants were investigated at baseline during 2013–2016 and at follow-up after 1 and 3 years. Preventive measures were managed within primary care. Within a CVD prevention program in Västerbotten County, Sweden, 3532 healthy individuals aged 40, 50 or 60 years were enrolled and 1:1 ran- domized 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). Methods: A Prospective Randomized Open Blinded End-point (PROBE) trial. 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. Objective: Non-adherence to guidelines and preventive measures is a major challenge, particularly so to ob- tain long-term adherence to lifestyle changes and recommended medication. 7, article id 100199 Article in journal (Refereed) Published Abstract Show others and affiliations 2021 (English) In: American Journal of Preventive Cardiology, Vol.
0 Comments
Leave a Reply. |