{"id":"54ee9007cf56","type":"article","url":"https://hartvaat.nl/2019/01/12/visualisatie-van-asymptomatische-atherosclerose-voor-cv-preventie-lancet-vipviza/","title":"Visualisatie van asymptomatische atherosclerose voor CV-preventie: Lancet VIPVIZA","title_en":"Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA): a pragmatic, open-label, randomised controlled trial.","category":"preventie","category_label":"Preventie","professions":["cardioloog","huisarts"],"tags":["atherosclerose","ezetimibe","hartkatheterisatie","hartrevalidatie","perifeer-vaatlijden","primaire-preventie","secundaire-preventie"],"journal":"Lancet (London, England)","doi":"10.1016/S0140-6736(18)32818-6","source_url":"https://doi.org/10.1016/S0140-6736(18)32818-6","authors":["Ulf Näslund","Nawi Ng","Anna Lundgren","Eva Fhärm","Christer Grönlund","Helene Johansson","Bernt Lindahl","Bertil Lindahl","Kristina Lindvall","Stefan K Nilsson","Maria Nordin","Steven Nordin","Emma Nyman","Joacim Rocklöv","Davide Vanoli","Lars Weinehall","Patrik Wennberg","Per Wester","Margareta Norberg"],"significance":7,"published":"2019-01-12","source_date":"2019-01-12","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/diabetes-type-1-en-hart/","https://hartvaat.nl/kennis/lipiden/ldl-cholesterol-mechanisme/"],"congress":"","summary_en":"The VIPVIZA pragmatic trial showed that visualizing atherosclerotic disease through ultrasound imaging and communicating the results to patients and doctors improved cardiovascular risk factor management, demonstrating the power of disease visualization for prevention.","created":"2026-07-03T10:27:43Z","updated":"2026-07-03T13:26:56Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Lancet VIPVIZA pragmatische trial die beeldvormingvisualisatie van subklinische atherosclerose onderzocht voor optimalisatie van cardiovasculaire preventie.","abstract_original":"BACKGROUND: Primary prevention of cardiovascular disease often fails because of poor adherence among practitioners and individuals to prevention guidelines. We aimed to investigate whether ultrasound-based pictorial information about subclinical carotid atherosclerosis, targeting both primary care physicians and individuals, improves prevention. METHODS: Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a pragmatic, open-label, randomised controlled trial that was integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease prevention programme in northern Sweden. Individuals aged 40, 50, or 60 years with one or more conventional risk factors were eligible to participate. Participants underwent clinical examination, blood sampling, and ultrasound assessment of carotid intima media wall thickness and plaque formation. Participants were randomly assigned 1:1 with a computer-generated randomisation list to an intervention group (pictorial representation of carotid ultrasound plus a nurse phone call to confirm understanding) or a control group (not informed). The primary outcomes, Framingham risk score (FRS) and European systematic coronary risk evaluation (SCORE), were assessed after 1 year among participants who were followed up. This study is registered with ClinicalTrials.gov, number NCT01849575. FINDINGS: 3532 individuals were enrolled between April 29, 2013, and June 7, 2016, of which 1783 were randomly assigned to the control group and 1749 were assigned to the intervention group. 3175 participants completed the 1-year follow-up. At the 1-year follow-up, FRS and SCORE differed significantly between groups (FRS 1·07 [95% CI 0·11 to 2·03, p=0·0017] and SCORE 0·16 [0·02 to 0·30, p=0·0010]). FRS decreased from baseline to the 1-year follow-up in the intervention group and increased in the control group (-0·58 [95% CI -0·86 to -0·30] vs 0·35 [0·08 to 0·63]). SCORE increased in both groups (0·13 [95% CI 0·09 to 0·18] vs 0·27 [0·23 to 0·30]). INTERPRETATION: This study provides evidence of the contributory role of pictorial presentation of silent atherosclerosis for prevention of cardiovascular disease. It supports further development of methods to reduce the major problem of low adherence to medication and lifestyle modification. FUNDING: Västerbotten County Council, the Swedish Research Council, the Heart and Lung Foundation, the Swedish Society of Medicine, and Carl Bennet Ltd, Sweden."}