Umeå University's logo

Background and objectives: We evaluated whether a pictorial representation of asymptomatic atherosclerosis based on carotid ultrasound examinations given to the participants and their physicians had an impact on the proportion of participants receiving prescriptions for lipid-lowering drugs during the following 465 days. The overall aim of the study was to optimize cardiovascular disease (CVD) prevention.

Methods: This study was performed within a CVD screening and prevention program in Vasterbotten County, Sweden 2013-2016. 3532 par- € ticipants were randomly assigned 1:1 to receive or not receive a simplified picture of an ultrasound scan by mail plus a phone call including a health dialogue with a trained nurse. The picture indicated vascular age and the presence of plaques, and was also sent to participants’ physicians. The control group received no information about the ultrasound. Data on prescriptions was collected from the County Council database.

Results: During the first 465 days, prescriptions of lipid-lowering drugs were higher in the intervention group compared with the control group among men (34.2% vs 21.3%, p<0.001) and women (25.8% vs 15.2% p<0.001). Corresponding proportions for first prescriptions were 19.2% vs 6.0% (p<0.001) and 16.6% vs 5.7% (p<0.001), respectively. Similar patterns were observed for participants with and without plaque, but with a higher proportion among those with plaque. Cholesterol level, diabetes, prescription of antihypertensives and previous myocardial infarction were in a multivariable logistic regression model associated with first prescriptions. Although prescriptions increased over the study period, 56% of participants with known plaque were not prescribed any lipid-lowering drug.

Conclusion: Provision of pictorial information on vascular age and carotid plaque based on ultrasound examination increased physician prescriptions of lipid-lowering drugs within the following 465 days.