![]() 6 The association between visual representations of asymptomatic diseases and the initiation of drug treatment has been evaluated in other medical fields. 4, 5 Ultrasonographic examinations for detecting carotid plaques and increased cIMT can therefore be used to improve the estimation of the likelihood of future CVD. 3 Although these measures are useful in identifying individuals with high risk, they are less sensitive in asymptomatic individuals with low to moderate risk among whom most cardiovascular events occur.īoth increased carotid intima-media thickness (cIMT) and presence of carotid plaques are associated with CVD. 1 Increased risk is often identified and communicated using traditional screening tools (eg, European Systematic Coronary Risk Evaluation) 2 and Framingham risk score). Trial Registration Identifier: NCT01849575īoth therapeutic drugs and lifestyle changes are effective in prevention of cardiovascular disease (CVD), although preventive drugs are often underused. There were no significant differences in the proportion with prescription of antihypertensive drugs in the intervention vs control groups after ultrasonography among men (58 of 482 vs 56 of 528 P = .47) and women (60 of 612 vs 64 of 615 P = .73).Ĭonclusions and Relevance The findings of this trial demonstrate that provision of pictorial information on vascular age and carotid plaques based on the results of ultrasonographic examination increased physician prescription of lipid-lowering drugs but not antihypertensive drugs within the following 465 days. First prescriptions of lipid-lowering drugs were higher in the intervention group vs the control group among men (118 of 639 vs 38 of 692 P < .001) and women (126 of 804 vs 38 of 817 P < .001). ![]() Results Of the 4177 individuals invited to enroll, 3532 participants were randomized and included in the analysis 1870 (52.9%) were women, 2278 (64.5%) were aged 60 years, 978 (27.7%) were 50 years, and 276 (7.8%) were 40 years. Data obtained through intention-to-treat analysis are presented as proportions of individuals with a prescription among those who had no baseline prescription for agents from these drug classes. Main Outcomes and Measures Two outcome measures of prescriptions of antihypertensive and lipid-lowering drugs within 465 days after ultrasonography was performed. Interventions Participants and their family physicians were randomly assigned 1:1 to receive or not receive pictorial information from carotid ultrasonographic determination of vascular age, assessed as carotid intima-media thickness and the presence of carotid plaques, combined with a follow-up call to participants by nurses. Data analysis was conducted from December 6, 2019, to April 2, 2020. Prescriptions for all participants were monitored for 465 days after the intervention. A total of 4177 individuals aged 40, 50, or 60 years participating in the Västerbotten Intervention Program who had low to moderate risk of CVD were invited to enroll in this trial from April 29, 2013, to June 7, 2016. Objective To evaluate whether pictorial information on participants’ asymptomatic atherosclerosis based on carotid ultrasonographic examinations to participants and their physicians had an effect on prescribing of lipid-lowering or antihypertensive drugs during the following 465 days.ĭesign, Setting, and Participants Visualization of Asymptomatic Atherosclerotic Disease for Optimum Cardiovascular Prevention is a pragmatic randomized clinical trial nested within the Västerbotten Intervention Program, a CVD screening and prevention program in Sweden with 60% to 70% participation rates and small social selection bias. Carotid intima-media thickness and carotid plaques are associated with cardiovascular disease (CVD), and their detection could possibly improve estimation of the likelihood of CVD and prescription of preventive drugs. ![]() Importance Preventive drugs are often underused. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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