Ultrasound Detection of Increased Carotid Intima-Media Thickness and Carotid Plaque in an Office Practice Setting: Does It Affect Physician Behavior or Patient Motivation?

Claudia E. Korcarz, Jeanne M. DeCara, Alan T. Hirsch, Emile R. Mohler, Bryan Pogue, John Postley, Wendy S. Tzou, James H. Stein

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Background: The aim of this multicenter study was to determine if identifying increased carotid intima-media thickness (CIMT) or carotid plaque during office-based ultrasound screening examinations could alter physicians' treatment plans and patients' motivation regarding health-related behaviors. Methods: Carotid ultrasound studies were performed by a nonsonographer clinician using a handheld system. Changes in physicians' treatment plans and patients' motivation on the basis of scan results were analyzed using multivariate regression. Results: There were 253 subjects (mean age, 58.1 ± 6.6 years). When increased CIMT or carotid plaque was detected, physicians were more likely to prescribe aspirin and lipid-lowering therapy (P < .001). Subjects were more likely to report increases in plans to take cholesterol-lowering medication (P = .002) and the perceived likelihood of having or developing heart disease (P = .004). Conclusions: Findings from office-based carotid ultrasound studies can influence physicians' prescriptions of evidence-based interventions. Patients with abnormal ultrasound findings recognize their increased cardiovascular risk and plan to take cholesterol-lowering medication.

Original languageEnglish (US)
Pages (from-to)1156-1162
Number of pages7
JournalJournal of the American Society of Echocardiography
Volume21
Issue number10
DOIs
StatePublished - Oct 2008

Bibliographical note

Funding Information:
The core laboratory and coordinating center for this study was the University of Wisconsin Atherosclerosis Imaging Research Program, University of Wisconsin School of Medicine and Public Health, Madison, WI (James H. Stein, MD, principal investigator [PI]; Claudia E. Korcarz, DVM, RDCS). The following individuals and institutions participated in this study: Heart Prevention Clinic of Idaho, Boise, ID (Bryan Pogue, MD, site PI; Kelli Sizemore; Amy Webb); New York Physicians, New York, NY (John Postley, MD, site PI; Maria Chan); University of Chicago Pritzker School of Medicine, Chicago, IL (Jeanne M. DeCara, MD, site PI; Kathy Furlong, RN); University of Minnesota School of Public Health and Minneapolis Heart Institute Foundation, Minneapolis, MN (Alan T. Hirsch, MD, site PI; Faye Imker-Witte; Kristi Jacobson); and University of Pennsylvania Medical School, Philadelphia, PA (Emile R. Mohler, MD, site PI; Wendy S. Tzou, MD). The steering committee included Dr Stein (study PI); Dr Hirsch (study co-PI); Dr DeCara (University of Chicago Pritzker School of Medicine); Patrick E. McBride, MD, MPH (University of Wisconsin School of Medicine and Public Health, Madison, WI); Christopher M. Rembold, MD (University of Virginia Medical School, Charlottesville, VA); Neil Stone, MD (Northwestern University Feinberg School of Medicine, Chicago, IL); and Dr Tzou.

Keywords

  • Atherosclerosis
  • Carotid arteries
  • Risk factors
  • Ultrasound

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