|
People
Don't Get the Picture on Heart Risk
Simply telling someone that he or she is at high risk of
heart attack or stroke is not enough to change behavior,
even if that information comes in the vivid form of a picture
of blood vessels on their way to serious trouble, a study
finds.
A group led by Dr. Patrick G. O'Malley, chief of the division
of general and internal medicine at Walter Reed Army Medical
Center, reports that only a continuing effort at changing
a person's lifestyle can reduce that risk.
The images they used came from electron beam tomography
(EBT), which shows calcium deposits in the heart and blood
vessels that are the early signs of future trouble. The
subjects were 450 symptom-free active duty Army personnel
aged 39 to 45.
They were divided into four groups. Some were shown the
EBT images immediately and left on their own. Others were
not told about their results for a year, without advice
about lifestyle changes. A third group got advice about
lifestyle changes and they were shown the EBT images a year
later. People in the fourth group saw their EBT images immediately
and were given continuing advice on changing lifestyle.
One year later, an overall reduction in risk factors --
smoking, blood pressure, better diet -- was seen only in
that fourth group, says a report in the May 7 issue of the
Journal of the American Medical Association. Using the assessment
scale developed by the Framingham Heart Study, which includes
all known cardiovascular risk factors, they found a reduction
about double that of the other groups.
It's an important finding because "this technology
has been widely used, based on a self-referral basis,"
O'Malley says. There are for-profit EBT centers around the
country that will provide blood vessel images, leaving the
follow-up to a family doctor or cardiologist.
But "general behavioral change is a difficult thing,"
O'Malley says. "Life is complex. Health can be affected
by societal reasons, social reasons."
Still, in some communities people are exposed to "fairly
aggressive advertising and marketing," says Dr. Philip
Greenland, chairman of the department of preventive medicine
at Northwestern University and author of an accompanying
editorial. "The people who run the scanners frequently
justify making them available to the public on the grounds
that it will lead people to make changes and follow appropriate
medical advice."
O'Malley's study shows that "EBT is no more potent
than other methods of describing risk" as a way to
achieve lifestyle changes, Greenland says. He acknowledges
that he has been skeptical all along, and the study results
"tend to support what I would have believed anyway."
It's not just EBT that Greenland is skeptical about. "The
evidence is pretty strong in relation to other tests as
well that information alone is not potent in changing behavior."
The fact that the people in the study were young and healthy
might have influenced the results, O'Malley says. "This
is worth testing in a group with higher prevalence of coronary
disease," he says. "We're looking for funding
for a study of a higher-prevalence cohort."
You can learn more about electron beam tomography and other
imaging techniques from the American
Heart Association, and Canadian
Heart and Stroke Foundation which also has a page on
how your lifestyle
affects your heart health.
Article Source: HealthDay
Article Author: Ed Edelson
Net Reference 101
|
