DOES CORONARY-ARTERY SCREENING BY ELECTRON-BEAM COMPUTED-TOMOGRAPHY MOTIVATE POTENTIALLY BENEFICIAL LIFE-STYLE BEHAVIORS

We evaluated the extent to which cardiovascular risk-reducing behavior s are initiated as a result of knowledge of newly detected coronary ar tery disease, based on test results from noninvasive electron beam com puted tomography (EBCT). A total of 703 men and women, aged 28 to 84 y ears, asymptomatic and without prior coronary disease, who had a basel ine EBCT coronary artery scan and basic medical history and risk facto r information completed a follow-up survey questioning them about heal th behaviors undertaken since their scan. Baseline calcium scores were significantly higher in those who subsequently reported consulting wi th a physician, or reported new hospitalization, coronary revasculariz ation ion, beginning aspirin usage, blood pressure medications, choles terol-lowering therapy, decreasing dietary fat, losing weight, beginni ng vitamin E, ones under more worry (all p <0.01). Other factors, incl uding reducing time worked, obtaining life insurance, losing employmen t, increased work absenteeism, increasing exercise, or stopping smokin g were not associated with coronary calcium. In logistic regression, a fter adjusting for age, gender, pre-existing high cholesterol, high bl ood pressure, cigarette smoking, and a positive family history of coro nary disease, the natural log of total calcium score remained associat ed with new aspirin usage, new cholesterol medication, consulting with a physician, losing weight, decreasing dietary fat, new coronary reva scularization (all p <0.01), but also new hospitalization (p <0.05) an d increased worry (p <0.001). The results suggest that potentially imp ortant risk-reducing behaviors may be reinforced by the knowledge of a positive coronary artery scan, independent of preexisting coronary ri sk factor status. (C) 1996 by Excerpta Medica, Inc.