Coronary CTA beats stress test for changing lifestyles

Individuals who underwent a coronary CT angiography (CCTA) exam were more motivated to adopt a healthy lifestyle than those who received an exercise echocardiography stress test, according to new research from the University of California, Los Angeles (UCLA).

The results in more than 10,000 individuals showed that a higher percentage of those undergoing CCTA adopted healthier lifestyle practices compared with stress-test takers. The positive steps included taking preventive medication, eating a healthy diet, and losing weight. These steps were adopted at lower rates among takers of echo stress tests.

The study findings showed that different tests lead to different rates of adoption of preventive care and lifestyle choices, reported Dr. Joseph Ladapo, assistant professor of medicine at UCLA's David Geffen School of Medicine, and colleagues (Journal of the American Heart Association, October 12, 2016).

To examine the factors that influenced people to adopt preventive medical therapy and healthier lifestyle practices, the group assigned 10,003 people (mean age 61, 53% female) randomly to CCTA or exercise electrocardiography or stress test. The groups had equivalent levels of risk factors. The researchers associated the preventive changes with major cardiovascular events and associated the preventive lifestyle changes with cardiovascular events.

After 60 days, more CCTA patients had adopted preventive measures such as taking aspirin (11.8% -versus 7.8% of stress-test participants), statins (12.7% versus 6.2%), and beta-blockers (8.1% versus 5.3%). More CCTA patients were also eating healthy, with lower rates of overweight status compared with the other group.

Some things weren't better in the CCTA group, however, including exercise, quitting smoking, and losing weight, which revealed no difference between the groups. And the interventions such as angioplasty showed stronger associations with preventive medications and lifestyle than the type of test the participants were given.

Different tests lead to different rates of adoption of preventive care and lifestyle choices, the authors concluded. National testing practices need to be revised to reduce variation and improve cardiovascular disease prevention across the board, they added.

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