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Reduced progression of carotid intima media thickness by personalised pictorial presentation of subclinical atherosclerosis in VIPVIZA: A randomised controlled trial
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0002-4060-4752
Umeå University, Faculty of Medicine, Department of Radiation Sciences.ORCID iD: 0000-0003-4288-1208
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0003-2078-3658
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
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2023 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 43, no 4, p. 232-241Article in journal (Refereed) Published
Abstract [en]

Objectives: Reduced progression of atherosclerosis can decrease the risk of cardiovascular disease (CVD). This study aimed at evaluating the effect of a pictorial intervention showing atherosclerotic severity on the progression of carotid atherosclerosis.

Methods: A prospective randomised open-label blinded end-point trial with participants aged 40–60 years enroled from a routine CVD prevention programme. The intervention group (n: 1575) and their treating physicians received an image based presentation of subclinical atherosclerotic severity measured by carotid ultrasound. The control group (n: 1579) did not receive any information about ultrasound results. Carotid ultrasound at baseline and at 3-year follow-up contained plaque detection and measurements of carotid intima media thickness (cIMT). The left, right and bilateral-mean-cIMT, plaque prevalence and total plaque area (TPA) at 3-year follow-up were compared between groups. Significance level was set to p = 0.01 to adjust for multiple comparisons.

Results: The intervention group revealed reduced cIMT progression in the left-mean-cIMT of −0.011 mm (p = 0.001) compared with the control group. The intervention effect on cIMT progression was most prominent in individuals with increased cIMT and plaque prevalence at baseline (−0.021 mm, p = 0.005). There were no differences in progression between groups for the right-and bilateral-mean-cIMT (−0.005 mm, p = 0.223 and −0.005 mm, p = 0.036, respectively), nor any differences between groups for plaque prevalence or TPA (odds ratio 0.88, p = 0.09 and 0.89, p = 0.21, respectively).

Conclusion: Pictorial presentation of subclinical atherosclerotic severity sent to both the individual and their treating physician resulted in significantly reduced left cIMT progression. Pictorial presentation has the potential to increase adherence in CVD prevention.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 43, no 4, p. 232-241
Keywords [en]
adherence, intervention, prevention, randomised controlled trial, ultrasound imaging
National Category
Cardiac and Cardiovascular Systems Physiology
Identifiers
URN: urn:nbn:se:umu:diva-204766DOI: 10.1111/cpf.12811ISI: 000921350300001PubMedID: 36642849Scopus ID: 2-s2.0-85147282676OAI: oai:DiVA.org:umu-204766DiVA, id: diva2:1738030
Funder
Visare NorrSwedish Society of MedicineSwedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Swedish Research Council, 521‐2013‐2708Swedish Research Council, 2016‐01891Swedish Research Council, 2017‐02246Region Västerbotten, ALFVLL‐298001Region Västerbotten, ALFVLL643391Available from: 2023-02-20 Created: 2023-02-20 Last updated: 2023-07-14Bibliographically approved

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Nyman, EmmaGrönlund, ChristerVanoli, DavideLiv, PerNorberg, MargaretaBengtsson, AnnaWennberg, PatrikWester, PerNäslund, Ulf

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Nyman, EmmaGrönlund, ChristerVanoli, DavideLiv, PerNorberg, MargaretaBengtsson, AnnaWennberg, PatrikWester, PerNäslund, Ulf
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Department of Public Health and Clinical MedicineDepartment of Radiation SciencesDepartment of Epidemiology and Global Health
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