Knowing heart risk may prompt healthy change
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Adults at risk for developing coronary heart disease seem to respond better to preventive treatment when their doctor tells them exactly what their risk is and how they can help lower their risk, results of a study suggest.
In the study, people who had frank discussions with their doctor about their coronary risk profile achieved greater improvement in their cholesterol levels than those who did not have these discussions.
It is well known that lowering levels of “bad” LDL cholesterol and raising levels of “good” HDL cholesterol reduces the chances of a heart attack and heart-related death. Yet patients don’t always stick to recommended lifestyle changes or their cholesterol medications.
The results of one recent study suggested that about one-third of people who stop taking their cholesterol medications do so because they are not convinced they need them.
This made Dr. Steven A. Grover of McGill University in Montreal, Quebec, and colleagues wonder whether boosting patients’ knowledge of their heart risk profile might help boost their adherence to heart-healthy ways.
To find out, they randomly assigned 3,053 adults being treated for cholesterol problems to usual care or to receive a 1-page computer printout displaying their probability of developing heart disease in the next 8 years based on their current lifestyle, blood pressure, cholesterol levels, and other risk indicators.
During the study, reported in the Archives of Internal Medicine, the printout group also received ongoing feedback on how much they could cut their risk through lifestyle modification and drug therapy.
A total of 2,687 patients completed the 12-month study, and the researchers saw that those in the intervention group who kept track of their heart risk profile had small but significantly greater improvements in their cholesterol profiles.
The patients who were better educated about their heart risk profile were also more likely to reach cholesterol targets, the investigators found.
Given the public health burden of heart disease, prevention is key, Grover and colleagues note in their report. “Communicating risk is consistent with many of the recommendations to improve adherence, including enhancing self-monitoring and using the support of family and friends.”
SOURCE: Archives of Internal Medicine, November 26, 2007.
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