Primary prevention of cardiovascular (CV) disease often fails because of poor adherence to evidence-based guidelines by both patients and clinicians. Might visual representations of patients’ existing atherosclerosis increase adherence to preventive guidelines?

Researchers randomized 3532 participants (age, >60; or age, >40 with ≥1 conventional CV risk factor) in a Swedish population-based CV prevention program to undergo carotid ultrasound examinations and to either receive or not receive a visual report of the results. Each patient’s report displayed a stylized representation of the ultrasound image and a gauge that compared vascular age with chronological age. Patients who received visual reports also received reinforcing phone calls from a nurse and copies of their reports 6 months later; their clinicians also received copies of their visual reports. Patients who did not receive visual reports received standard guideline-based preventive care.

After 1 year, mean Framingham Risk Score decreased from 12.9 to 12.2 in patients who received visual reports and increased from 12.9 to 13.3 among controls (a statistically significant between-groups difference). A similar pattern was noted for the European Systematic Coronary Risk Evaluation score. The effect of the intervention was greatest among patients with the highest baseline CV risk.