VIPVIZA - VIsualiZation of asymptomatic Atherosclerotic disease for optimum cardiovascular prevention ─ a randomized controlled trial nested in the Västerbotten Intervention Program

SND-ID: 2020-204-1.

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Alternative title

VIPVIZA

Creator/Principal investigator(s)

Margareta Norberg - Umeå University, Department of Epidemiology and Global Health orcid

Ulf Näslund - Umeå University, Public Health and Clinical Medicine

Patrik Wennberg - Umeå University, Family Medicine

Umeå University, Department of Public Health and Clinical Medicine

Research principal

Umeå University - Department of Public Health and Clinical Medicine rorId

Description

The aim of the project is to develop better methods for prevention of cardiovascular diseases (CVD). It is based on the hypothesis that image-based information on subclinical atherosclerosis (i) increases the precision in the assessment of risk of CVD, (ii) improves communication and understanding of the risk, and as a consequence (iii) the motivation for and adherence to evidence-based pharmacological treatment and lifestyle modification will increase. In addition to conventional risk factor assessment and CVD prevention within the framework of Västerbotten Intervention Program.

3500 healthy participants with low/moderate risk of CVD underwent ultrasound examination of the carotid arteries and were randomized to two groups. In the intervention group, the participants and their doctors received pictorial and graphic information in color about the participant’s subclinical atherosclerosis. No information about the ultrasound results was given to the control group. Follow-up after 1, 3 and 6.5 years includes sampling regarding clinical risk factors, blood for biomarker analyses, extensive quest

... Show more..
The aim of the project is to develop better methods for prevention of cardiovascular diseases (CVD). It is based on the hypothesis that image-based information on subclinical atherosclerosis (i) increases the precision in the assessment of risk of CVD, (ii) improves communication and understanding of the risk, and as a consequence (iii) the motivation for and adherence to evidence-based pharmacological treatment and lifestyle modification will increase. In addition to conventional risk factor assessment and CVD prevention within the framework of Västerbotten Intervention Program.

3500 healthy participants with low/moderate risk of CVD underwent ultrasound examination of the carotid arteries and were randomized to two groups. In the intervention group, the participants and their doctors received pictorial and graphic information in color about the participant’s subclinical atherosclerosis. No information about the ultrasound results was given to the control group. Follow-up after 1, 3 and 6.5 years includes sampling regarding clinical risk factors, blood for biomarker analyses, extensive questionnaires and interviews.

At 3 and 6.5 years the ultrasound examination was repeated and all participants and their doctors were informed about the results. The database also includes register data regarding prescriptions of preventive medication, exposure data for air pollutants, data from health examinations within the VIP 10 and 20 years before VIPVIZA, and for men conscription data.

After 10 years, registry data on endpoints, CVD morbidity and mortality will be collected.

Access to VIPVIZA's data portal and research data from VIPVIZA is possible in collaboration with researchers within the VIPVIZA project. For further information, contact PI Ulf Näslund ulf.naslund@umu.se Show less..

Data contains personal data

Yes

Sensitive personal data

Yes

Type of personal data

Medical data at individual level

Code key exists

Yes

Language

Method and outcome

Unit of analysis

Population

Healthy subjects aged 40-60 years at low/moderate risk of cardiovascular disease

Study design

Randomised controlled trial (RCT)

Description of study design

Pagmatic open-label, randomised controlled trial with masked evaluators (PROBE)

Sampling procedure

Other
Subjects having at least one cardiovascular risk factor at the occasion of participation in the Västerbotten INtervention Programme: 1) age 40 years and a first-degree relative with a history oc cardiovascular disease at an age younger than 60 years, abdominal obesity, hypertension, diabetes, LDL-cholesterol >= 4.5 mmol/l, smoking. 3) Age 60 years.
Exclusion criterion: More than 50% narrowing of the lumen of carotid areteries

Time period(s) investigated

2013 – Ongoing

Biobank is connected to the study

Yes

Number of individuals/objects

3532

Data format / data structure

Data collection

Data collection 1

  • Mode of collection: Registry extract and/or access to biobank sample
  • Description of the mode of collection: VIP historical data 20 years before basline
  • Time period(s) for data collection: 1992 – 1998

Data collection 2

  • Mode of collection: Registry extract and/or access to biobank sample
  • Description of the mode of collection: VIP Historical data 10 years before baseline
  • Time period(s) for data collection: 2000 – 2009
  • Source of the data: Registers/Records/Accounts

Data collection 3

  • Mode of collection: Registry extract and/or access to biobank sample
  • Description of the mode of collection: The Swedish Prescribed Drug Register
  • Time period(s) for data collection: 2011-01-02 – 2020-09-30
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Data collection 1

  • Mode of collection: Registry extract and/or access to biobank sample
  • Description of the mode of collection: VIP historical data 20 years before basline
  • Time period(s) for data collection: 1992 – 1998

Data collection 2

  • Mode of collection: Registry extract and/or access to biobank sample
  • Description of the mode of collection: VIP Historical data 10 years before baseline
  • Time period(s) for data collection: 2000 – 2009
  • Source of the data: Registers/Records/Accounts

Data collection 3

  • Mode of collection: Registry extract and/or access to biobank sample
  • Description of the mode of collection: The Swedish Prescribed Drug Register
  • Time period(s) for data collection: 2011-01-02 – 2020-09-30

Data collection 4

  • Mode of collection: Registry extract and/or access to biobank sample
  • Description of the mode of collection: VIP baseline (lifestyle)
  • Time period(s) for data collection: 2012-04-11 – 2016-06-01
  • Source of the data: Registers/Records/Accounts

Data collection 5

  • Mode of collection: Physical measurements and tests
  • Description of the mode of collection: Ultrasound baseline
  • Time period(s) for data collection: 2013-04-27 – 2016-06-07
  • Instrument: - CardioHealth Station, Panasonic Healthcare Corporation of North America, Newark, NJ, USA - A portable ultrasound system with a linear 7MHz transducer, Ultrasound 2D, B-mode settings including depth, gain and focus point were optimized for each participant manually by the sonographer. CardioHealth Station, Panasonic Healthcare Corporation of North America, Newark, NJ, USA
  • Source of the data: Research data

Data collection 6

  • Mode of collection: Self-administered questionnaire
  • Description of the mode of collection: Psychological (Problem management) , baseline
  • Time period(s) for data collection: 2013-04-29 – 2016-06-07
  • Instrument: Brief Cope - Self-report questionnaire designed to measure effective and ineffective ways to cope with a stressful life event
  • Instrument: LOT-R Life Orientation Test-Revised - Self-report instrument that assesses one’s dispositional level of optimism/pessimism
  • Instrument: HADS Hpiostal Anxiety and Depression Scale - Self-assessment form for anxiety (subscale HADS-anxiety, 7 questions) and depression (subscale HADS-depression, 7 questions)
  • Instrument: GSE, General Self-Efficacy Scale - Self-report measure of general self-efficacy, an individual's belief in his or her capacity to execute behaviors necessary to produce performance attainments
  • Instrument: Brief Health Literacy Screen (BHLS) - Three questions on self-rated health literacy according to Chew
  • Instrument: - Self-rated risk of CVD - VAS-scale
  • Source of the data: Research data

Data collection 7

  • Mode of collection: Self-administered questionnaire
  • Description of the mode of collection: Lifestyle 1 year
  • Time period(s) for data collection: 2014-05-08 – 2017-11-01
  • Source of the data: Research data

Data collection 8

  • Mode of collection: Biological tests
  • Description of the mode of collection: Lifestyle 1 year
  • Time period(s) for data collection: 2014-05-08 – 2017-11-01
  • Data collector: Umeå University
  • Source of the data: Research data

Data collection 9

  • Mode of collection: Self-administered questionnaire
  • Description of the mode of collection: Clinical CVD risk factors and lifestyle habits 3 year
  • Time period(s) for data collection: 2016-01-14 – 2019-06-14

Data collection 10

  • Mode of collection: Measurements and tests
  • Description of the mode of collection: Clinical CVD risk factors and lifestyle habits 3 year
  • Time period(s) for data collection: 2016-01-16 – 2019-06-14

Data collection 11

  • Mode of collection: Physical measurements and tests
  • Description of the mode of collection: Ultrasound 3 year
  • Time period(s) for data collection: 2016-09-05 – 2019-05-28
  • Instrument: - CardioHealth Station, Panasonic Healthcare Corporation of North America, Newark, NJ, USA - A portable ultrasound system with a linear 7MHz transducer, Ultrasound 2D, B-mode settings including depth, gain and focus point were optimized for each participant manually by the sonographer. CardioHealth Station, Panasonic Healthcare Corporation of North America, Newark, NJ, USA
  • Source of the data: Research data

Data collection 12

  • Mode of collection: Self-administered questionnaire
  • Description of the mode of collection: Psykologiska faktorer och reaktioner på VIPVIZA interventionen (Problemhantering), efter 3 år
  • Time period(s) for data collection: 2016-09-05 – 2019-05-28
  • Instrument: - Specific VIPVIZA questionnaire - Self-rated risk of CVDm Specific self-efficacy, attitudes and norms related to life style habits. To the intervention group: Emotional and cognitive reactions and impact of the intervention
  • Instrument: HADS Hospital Anxiety Depression Scale - Self-assessment form for anxiety (subscale HADS-anxiety, 7 questions) and depression (subscale HADS-depression, 7 questions)
  • Instrument: GSE General Self Efficacy Scale - Self-report measure of general self-efficacy, an individual's belief in his or her capacity to execute behaviors necessary to produce performance attainments
  • Instrument: BHLS Brief Health Literacy Screen - Three questions on self-rated health literacy, according to Chew
  • Instrument: SMBQ Shirom-Melamed Burnout Questionnaire - Questionnaire to evaluate burnout
  • Instrument: LOT-R Life Orientation Test - Revised - Self-report instrument that assesses one’s dispositional level of optimism/pessimism
  • Instrument: Brief Cope - Self-report questionnaire designed to measure effective and ineffective ways to cope with a stressful life event

Data collection 13

  • Description of the mode of collection: Included study participants
  • Time period(s) for data collection: 2017-01-19
  • Instrument: Case Report Form
  • Source of the data: Research data

Data collection 14

  • Mode of collection: Registry extract and/or access to biobank sample
  • Description of the mode of collection: Military service mustering register
  • Data collector: Riksarkivet
  • Source of the data: Registers/Records/Accounts

Data collection 15

  • Mode of collection: Biological tests
  • Description of the mode of collection: Included study participants
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Geographic coverage

Geographic spread

Geographic location: Västerbotten County

Geographic description: Region Västerbotten

Highest geographic unit

Region

Administrative information

Responsible department/unit

Department of Public Health and Clinical Medicine

Contributor(s)

Wolfgang Lohr - Umeå University, Department of Epidemiology and Global HEalth

Funding 1

  • Funding agency: The Swedish Research Council
  • Funding agency's reference number: Dnr 521-2013-2708, 2016-01891, 2017-02246

Funding 2

  • Funding agency: Region Västerbotten
  • Funding agency's reference number: ALFVLL-298001, ALFVLL-643391

Funding 3

  • Funding agency: The Heart and Lung Foundation
  • Funding agency's reference number: Dnr 20150369, 20170481)

Funding 4

  • Funding agency: SKANDIA Risk & Health

Funding 5

  • Funding agency: Swedish Society of Medicine
  • Funding agency's reference number: 405351, 503111
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Funding 1

  • Funding agency: The Swedish Research Council
  • Funding agency's reference number: Dnr 521-2013-2708, 2016-01891, 2017-02246

Funding 2

  • Funding agency: Region Västerbotten
  • Funding agency's reference number: ALFVLL-298001, ALFVLL-643391

Funding 3

  • Funding agency: The Heart and Lung Foundation
  • Funding agency's reference number: Dnr 20150369, 20170481)

Funding 4

  • Funding agency: SKANDIA Risk & Health

Funding 5

  • Funding agency: Swedish Society of Medicine
  • Funding agency's reference number: 405351, 503111

Funding 6

  • Funding agency: Carl Bennet Ltd, Sweden

Funding 7

  • Funding agency: Visare Norr (the four Northern Regions)
  • Funding agency's reference number: 465621, 561591, 741711, 931135

Funding 8

  • Funding agency: The Heart Foundation in Northern Sweden

Funding 9

  • Funding agency: The Swedish Insurance Society
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Ethics Review

Swedish Ethical Review Authority - Ref. Dnr 2011-441-31M. Amendments:Dnr 2012-463-32M, Dnr 2013-373-32M, Dnr 2016-245-32M, Dnr 2017-95-32M, Dnr 2018-182-32, Dnr 2018-482-32M, Dnr 2019-0691, Dnr Ö 23-2020/3.1

Topic and keywords

Research area

Cardiac and cardiovascular systems (Standard för svensk indelning av forskningsämnen 2011)

Radiology, nuclear medicine and medical imaging (Standard för svensk indelning av forskningsämnen 2011)

Clinical laboratory medicine (Standard för svensk indelning av forskningsämnen 2011)

General practice (Standard för svensk indelning av forskningsämnen 2011)

Public health, global health, social medicine and epidemiology (Standard för svensk indelning av forskningsämnen 2011)

Medical biotechnology (focus on cell biology (incl. stem cell biology), molecular biology, microbiology, biochemistry or biopharmacy) (Standard för svensk indelning av forskningsämnen 2011)

Psychology (Standard för svensk indelning av forskningsämnen 2011)

Publications

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Vanoli, D. (2017). Vascular ultrasound for the assessment of carotid atherosclerosis [PhD dissertation, Umeå University]. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-139538
ISBN: 978-91-7601-748-7
URN: urn:nbn:se:umu:diva-139538

Vanoli, D., Lindqvist, P., Wiklund, U., Henein, M., & Näslund, U. (2013). Fully automated on-screen carotid intima-media thickness measurement : a screening tool for subclinical atherosclerosis. Journal of Clinical Ultrasound, 41(6), 333–339. https://doi.org/10.1002/jcu.22041
URN: urn:nbn:se:umu:diva-78429
DOI: https://doi.org/10.1002/jcu.22041

Vanoli, D., Wiklund, U., Lindqvist, P., Henein, M., & Näslund, U. (2014). Successful novice’s training in obtaining accurate assessment of carotid IMT using an automated ultrasound system. European Heart Journal Cardiovascular Imaging, 15(6), 637–642. https://doi.org/10.1093/ehjci/jet254
DOI: https://doi.org/10.1093/ehjci/jet254
URN: urn:nbn:se:umu:diva-91057

Lindahl, B., Norberg, M., Johansson, H., Lindvall, K., Ng, N., Nordin, M., Nordin, S., Näslund, U., Persson, A., Vanoli, D., & Schulz, P. J. (2020). Health literacy is independently and inversely associated with carotid artery plaques and cardiovascular risk. European Journal of Preventive Cardiology, 27(2), 209–215. https://doi.org/10.1177/2047487319882821
DOI: https://doi.org/10.1177/2047487319882821
URN: urn:nbn:se:umu:diva-165791

Nyman, E., Vanoli, D., Näslund, U., & Grönlund, C. (2020). Inter-sonographer reproducibility of carotid ultrasound plaque detection using Mannheim consensus in subclinical atherosclerosis. Clinical Physiology and Functional Imaging, 40(1), 46–51. https://doi.org/10.1111/cpf.12602
DOI: https://doi.org/10.1111/cpf.12602
URN: urn:nbn:se:umu:diva-165443

Näslund, U., Ng, N., Lundgren, A., Fhärm, E., Grönlund, C., Johansson, H., Lindahl, B., Lindahl, B., Lindvall, K., Nilsson, S. K., Nordin, M., Nordin, S., Nyman, E., Rocklöv, J., Vanoli, D., Weinehall, L., Wennberg, P., Wester, P., & Norberg, M. (2019). Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) : a pragmatic, open-label, randomised controlled trial. The Lancet, 393(10167), 133–142. https://doi.org/10.1016/S0140-6736(18)32818-6
DOI: https://doi.org/10.1016/S0140-6736(18)32818-6
URN: urn:nbn:se:umu:diva-154318

Nyman, E., Lindqvist, P., Näslund, U., & Grönlund, C. (2018). Risk marker variability in subclinical carotid plaques based on ultrasound is influenced by cardiac phase, echogenicity and size. In Ultrasound in Medicine and Biology (Vol. 44, Issue 8, pp. 1742–1750). https://doi.org/10.1016/j.ultrasmedbio.2018.03.013
DOI: https://doi.org/10.1016/j.ultrasmedbio.2018.03.013
URN: urn:nbn:se:umu:diva-150664
SwePub: oai:DiVA.org:umu-150664

Sjölander, M., Carlberg, B., Norberg, M., Näslund, U., & Ng, N. (n.d.). Prescription of Lipid-Lowering and Antihypertensive Drugs Following Pictorial Information About Subclinical Atherosclerosis A Secondary Outcome of a Randomized Clinical Trial. JAMA Netw Open. 2021;4(8):e2121683. https://doi.org/10.1001/jamanetworkopen.2021.21683
DOI: https://doi.org/10.1001/jamanetworkopen.2021.21683
URN: urn:nbn:se:umu:diva-187088
SwePub: oai:gup.ub.gu.se/307669

Bengtsson, A., Lindvall, K., Norberg, M., & Fhärm, E. (2021). Increased knowledge makes a difference!–general practitioners’ experiences of pictorial information about subclinical atherosclerosis for primary prevention: an interview study from the VIPVIZA trial. Scandinavian Journal of Primary Health Care, 39(1), 77-84. https://doi.org/10.1080/02813432.2021.1882083
URN: urn:nbn:se:umu:diva-181026
DOI: https://doi.org/10.1080/02813432.2021.1882083
SwePub: oai:DiVA.org:umu-181026

Rohlén, R., Jiang, B., Nyman, E., Wester, P., Näslund, U. and Grönlund, C. (2023), Interframe Echo Intensity Variation of Subregions and Whole Plaque in Two-Dimensional Carotid Ultrasonography. J Ultrasound Med, 42: 1033-1046. https://doi.org/10.1002/jum.16114
URN: urn:nbn:se:umu:diva-200460
DOI: https://doi.org/10.1002/jum.16114
SwePub: oai:DiVA.org:umu-200460

Nilsson Sommar, J., Norberg, M., Grönlund, C., Segersson, D., Näslund, U., & Forsberg, B. (2022). Long-term exposure to particulate air pollution and presence and progression of carotid artery plaques : A northern Sweden VIPVIZA cohort study. In Environmental Research (No. 113061; Vol. 211). https://doi.org/10.1016/j.envres.2022.113061
URN: urn:nbn:se:umu:diva-192989
DOI: https://doi.org/10.1016/j.envres.2022.113061
SwePub: oai:DiVA.org:umu-192989

Bengtsson, A., Norberg, M., Ng, N., Carlberg, B., Grönlund, C., Hultdin, J., Lindahl, B., Lindahl, B., Nordin, S., Nyman, E., Wennberg, P., Wester, P., & Näslund, U. (2021). The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk : results from the VIPVIZA randomized clinical trial. In American Journal of Preventive Cardiology (No. 100199; Vol. 7). https://doi.org/10.1016/j.ajpc.2021.100199
URN: urn:nbn:se:umu:diva-186686
DOI: https://doi.org/10.1016/j.ajpc.2021.100199
SwePub: oai:DiVA.org:umu-186686

Holmberg, H., Sjölander, M., Glader, E.-L., Näslund, U., Carlberg, B., Norberg, M., & Själander, A. (2022). Time to initiation of lipid-lowering drugs for subclinical atherosclerosis : sub-study of VIPVIZA randomized controlled trial, with single-arm cross-over. In European Heart Journal Open (No. oeac003; Vol. 2, Issue 1). https://doi.org/10.1093/ehjopen/oeac003
DOI: https://doi.org/10.1093/ehjopen/oeac003
URN: urn:nbn:se:umu:diva-201549
SwePub: oai:DiVA.org:umu-201549

Kovrov, O., Landfors, F., Saar-Kovrov, V., Näslund, U., & Olivecrona, G. (2022). Lipoprotein size is a main determinant for the rate of hydrolysis by exogenous LPL in human plasma. In Journal of Lipid Research (No. 100144; Vol. 63, Issue 1). https://doi.org/10.1016/j.jlr.2021.100144
URN: urn:nbn:se:umu:diva-191885
DOI: https://doi.org/10.1016/j.jlr.2021.100144
SwePub: oai:DiVA.org:umu-191885

Schulz, P. J., Lindahl, B., Hartung, U., Näslund, U., Norberg, M., & Nordin, S. (2022). The right pick : Does a self-assessment measurement tool correctly identify health care consumers with inadequate health literacy? In Patient Education and Counseling (Vol. 105, Issue 4, pp. 926–932). https://doi.org/10.1016/j.pec.2021.07.045
URN: urn:nbn:se:umu:diva-186967
DOI: https://doi.org/10.1016/j.pec.2021.07.045
SwePub: oai:DiVA.org:umu-186967

Andersson, E. M., Liv, P., Nordin, S., Näslund, U., & Lindvall, K. (2024). Does a multi-component intervention including pictorial risk communication about subclinical atherosclerosis improve perceptions of cardiovascular disease risk without deteriorating efficacy beliefs? In Social Science and Medicine (No. 116530; Vol. 341). https://doi.org/10.1016/j.socscimed.2023.116530
URN: urn:nbn:se:umu:diva-218586
DOI: https://doi.org/10.1016/j.socscimed.2023.116530
SwePub: oai:DiVA.org:umu-218586

Salvador, D., Liv, P., Norberg, M., Pahud de Mortanges, A., Saner, H., Glisic, M., Nicoll, R., Muka, T., Nyman, E., Bano, A., & Näslund, U. (2023). Changes in fasting plasma glucose and subclinical atherosclerosis : a cohort study from VIPVIZA trial. In Atherosclerosis. https://doi.org/10.1016/j.atherosclerosis.2023.117326
DOI: https://doi.org/10.1016/j.atherosclerosis.2023.117326
URN: urn:nbn:se:umu:diva-216637
SwePub: oai:DiVA.org:umu-216637

Nordin, S., Norberg, M., Braf, I., Johansson, H., Lindahl, B., Lindvall, K., Nordin, M., Nyman, E., Vallström, C., Wennberg, P., Liv, P., & Näslund, U. (2023). Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age. In Psychology and Health. https://doi.org/10.1080/08870446.2023.2286296
DOI: https://doi.org/10.1080/08870446.2023.2286296
URN: urn:nbn:se:umu:diva-217344
SwePub: oai:DiVA.org:umu-217344

Bengtsson, A., Nyman, E., Grönlund, C., Wester, P., Näslund, U., Fhärm, E., & Norberg, M. (2023). Multi-view carotid ultrasound is stronger associated with cardiovascular risk factors than presence of plaque or single carotid intima media thickness measurements in subclinical atherosclerosis. In The International Journal of Cardiovascular Imaging (Vol. 39, Issue 8, pp. 1461–1471). https://doi.org/10.1007/s10554-023-02868-0
DOI: https://doi.org/10.1007/s10554-023-02868-0
URN: urn:nbn:se:umu:diva-209575
SwePub: oai:DiVA.org:umu-209575

Ali, H., Nyman, E., Näslund, U., & Grönlund, C. (2023). Translation of atherosclerotic disease features onto healthy carotid ultrasound images using domain-to-domain translation. In Biomedical Signal Processing and Control (No. 104886; Vol. 85). https://doi.org/10.1016/j.bspc.2023.104886
URN: urn:nbn:se:umu:diva-206526
DOI: https://doi.org/10.1016/j.bspc.2023.104886
SwePub: oai:DiVA.org:umu-206526

Fortuin-de Smidt, M., Bergman, F., Grönlund, C., Hult, A., Norberg, M., Wennberg, M., & Wennberg, P. (2023). Early adulthood exercise capacity, but not muscle strength, associates with subclinical atherosclerosis 40 years later in Swedish men. In European Journal of Preventive Cardiology (Vol. 30, Issue 5, pp. 407–415). https://doi.org/10.1093/eurjpc/zwad007
URN: urn:nbn:se:umu:diva-206445
DOI: https://doi.org/10.1093/eurjpc/zwad007
SwePub: oai:DiVA.org:umu-206445

Andersson, E. M., Johansson, H., Nordin, S., & Lindvall, K. (2022). Cognitive and emotional reactions to pictorial-based risk communication on subclinical atherosclerosis : a qualitative study within the VIPVIZA trial. In Scandinavian Journal of Primary Health Care (Vol. 41, Issue 1, pp. 69–80). https://doi.org/10.1080/02813432.2023.2178850
URN: urn:nbn:se:umu:diva-205734
DOI: https://doi.org/10.1080/02813432.2023.2178850
SwePub: oai:DiVA.org:umu-205734

Nyman, E., Grönlund, C., Vanoli, D., Liv, P., Norberg, M., Bengtsson, A., Wennberg, P., Wester, P., & Näslund, U. (2023). Reduced progression of carotid intima media thickness by personalised pictorial presentation of subclinical atherosclerosis in VIPVIZA : A randomised controlled trial. In Clinical Physiology and Functional Imaging (Vol. 43, Issue 4, pp. 232–241). https://doi.org/10.1111/cpf.12811
DOI: https://doi.org/10.1111/cpf.12811
URN: urn:nbn:se:umu:diva-204766
SwePub: oai:DiVA.org:umu-204766

Nyman, E., Liv, P., Wester, P., Näslund, U., & Grönlund, C. (2023). Carotid wall echogenicity at baseline associates with accelerated vascular aging in a middle-aged population. In The International Journal of Cardiovascular Imaging (Vol. 39, Issue 3, pp. 575–583). https://doi.org/10.1007/s10554-022-02760-3
URN: urn:nbn:se:umu:diva-204476
DOI: https://doi.org/10.1007/s10554-022-02760-3
SwePub: oai:DiVA.org:umu-204476

Andersson, E. M., Lindvall, K., Wennberg, P., Johansson, H., & Nordin, S. (2024). From risk communication about asymptomatic atherosclerosis to cognitive and emotional reactions and lifestyle modification. In BMC Psychology (No. 47; Vol. 12, Issue 1). https://doi.org/10.1186/s40359-023-01467-x
URN: urn:nbn:se:umu:diva-218585
DOI: https://doi.org/10.1186/s40359-023-01467-x
SwePub: oai:DiVA.org:umu-218585

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