title: Information given to postmenopausal women on coronary computed tomography may influence cardiac risk reduction efforts.
abstract: OBJECTIVE
  Cardiovascular disease (CVD) is largely preventable through appropriate risk-factor modification. We sought to compare effects of comprehensive cardiac risk factor screening with and without computed tomography (CT) imaging of the coronary arteries on behavior change related to cardiac risk in postmenopausal women.
  
  
  METHODS
  56 postmenopausal women were randomized to alternative screening programs and followed for 1 year.
  
  
  RESULTS
  Subjects randomized (n=26) to the CT imaging group were shown images of their coronary arteries and received an interpretation from a radiologist. Most subjects in the CT group had a very low-risk (73.1%) coronary calcification score at baseline. Systolic blood pressure, total cholesterol, triglyceride, LDL, and cholesterol/HDL ratio declined significantly in the conventional screening group, but not in the CT imaging group (P<0.05). As compared to baseline values, study participation lead to significant reductions in total cholesterol, HDL, LDL, and blood pressure at 6 months (P<0.05) and triglyceride (P<0.05) at 12 months.
  
  
  CONCLUSIONS
  CVD risk-screening programs can facilitate cardiac risk reduction in women, but these data do not support an independent benefit of coronary CT imaging in a low-to-moderate risk group. The possibility of a deleterious effect of imaging on patient commitment to lifestyle changes is suggested.
authors.affiliation: Yale Prevention Research Center, 130 Division Street, Derby, CT 06418, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Lederman
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ballard
authors.forename: Valentine Y
authors.initials: VY
authors.lastname: Njike
authors.forename: Laurie
authors.initials: L
authors.lastname: Margolies
authors.forename: David L
authors.initials: DL
authors.lastname: Katz
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002114:Calcinosis; D002318:Cardiovascular Diseases / Q000517:prevention & control / Q000523:psychology*; D002784:Cholesterol / Q000097:blood; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009042:Motivation; D017698:Postmenopause; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D014057:Tomography, X-Ray Computed
chemical_list: D008055:Lipids; D002784:Cholesterol