Original Title: Efectividad de la comunicación del riesgo cardiovascular

Authors' objectives: The objective of this review is to identify studies evaluating the effectiveness of strategies to communicate cardiovascular risk to patients and general population, in order to produce changes in lifestyle and the application of appropriate medical treatment towards reducing such cardiovascular risk.

Authors' results and conclusions: RESULTS: The electronic search produced 2617 references once duplicates were removed. One hundred and ninety six were selected by title, of which 39 were selected for full text reading, being finally included 11 references relating to 10 studies. After adding the references identified by manual search, 23 references were finally included, referring to 19 RCTs (seven of them were clusters RCTs). The included studies show mixed effects on cardiovascular risk reduction, with about half of the studies obtaining statistically significant effects for intervention in risk communication. These effects were of low intensity, but given the prevalence of CVD they must be considered relevant from the standpoint of public health. Regarding risk factors, the most consistent finding has been found in the reduction of blood lipid levels, but effects were also of low intensity. For the remaining outcomes (blood pressure, BMI, risk perception, beginning and / or adherence to medical therapy, changes in lifestyle and variables related to decision making, emotional reactions) the results are inconsistent or insufficient. CONCLUSIONS: Interventions in cardiovascular risk communication show inconsistent results. In about half of the evaluated studies there have been small intensity reductions in cardiovascular risk and blood pressure levels, and 70% of interventions have obtained statistically significant reductions in levels of low density lipoproteins. These results should be restricted to primary prevention interventions, and seem more intense in participants with higher baseline risk. There have been no negative effects on health outcomes, not on emotional responses or decision-making processes of the participants. Discussed effects were accompanied by changes in lifestyle (mainly in food and in a lesser extent on tobacco consumption), although these results also were inconsistent or insufficient. In general, interventions do not seem to produce significant results on the initiation or modification of drug treatment, nor on adherence to treatment. There is no evidence that the intensity of educational or counselling interventions on changes in life style affects the occurrence or intensity of significant results. In summary, the results obtained, although not a strong evidence suggest that personalized cardiovascular risk communication can produce positive effects in reducing the risk, at least in people without diagnosed CVD and especially in those at high risk. However, more research is needed to conclude to what extent these positive effects are due solely to the assessment process and risk communication, or to the implementation of additional educational or counselling interventions on changes in lifestyle, and to the intensity level of such interventions.

Authors' methods: The following electronic databases were consulted (up to June 2010): MEDLINE (from 1950), EMBASE (from 1980), PsychInfo (from 1887), CINAHL (from 1981) and Cochrane (from 1800). Randomized controlled trials (RCTs) or studies with a comparative design were included, that evaluated interventions consisting of cardiovascular risk communication in a personalized manner, either alone or in conjunction with other interventions aimed at reducing risk, such as decision aids or behaviour change programs. The quality of the studies was assessed using the Jadad scale, by two reviewers independently.

Project Status: Completed

Year Published: 2010

URL for published report: https://sescs.es/efectividad-de-la-comunicacion-del-riesgo-cardiovascular/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es