A new substudy from a randomized clinical trial conducted in Scotland reveals that coronary computed tomography (CT) angiography leads to a greater adoption of healthy lifestyle behaviors and increased acceptance of preventive therapies compared to traditional cardiovascular risk scoring. The findings, published in JAMA Cardiology, indicate that viewing coronary atherosclerosis is an effective motivator for people at risk of cardiovascular disease to make positive health changes.

The study enrolled 400 asymptomatic individuals aged 40 to 70 years who had at least one cardiovascular risk factor and no history of cardiovascular disease. Participants were randomized to receive either guideline-based cardiovascular risk scoring (n = 195) or coronary CT angiography (n = 205). All participants were provided with standard lifestyle counseling, while preventive therapies (statins and antiplatelet agents) were recommended based on their risk scores or CT findings.

At the 6-month follow-up, participants in the CT angiography group were significantly more likely to comply with the National Institute for Health and Care Excellence (NICE) recommendations regarding diet, BMI, smoking cessation, and physical activity (17% vs 6%; odds ratio [OR], 3.42).

Although fewer individuals in the CT group were advised to start preventive medications compared with the risk score group (51% vs. 75%), those who received such recommendations were more likely to follow through (77% vs. 46%). There was a comparable overall statin use between groups (44% vs 35%; OR, 1.43) and a higher use of antiplatelet therapy in the CT group (40% vs 0.5%).