When people can see their heart disease risk, they're more likely to take action to reduce it.
For years, doctors have communicated cardiovascular risk using numbers and percentages — telling patients they have a "15% chance of a heart attack in the next 10 years." But what does that really mean to someone who feels perfectly healthy?
Baker Institute researchers investigated whether showing people actual images of plaque building up in their arteries would be more powerful than statistics alone. The results demonstrate that visual risk communication — letting patients see early signs of disease in their own body — can significantly improve risk factor management and medication adherence.
This research is reshaping how we talk to patients about preventing heart disease, particularly those with hidden atherosclerosis (plaque buildup) who have no symptoms yet.
Why this matters
Many Australians are living with early-stage cardiovascular disease without knowing it. They feel fine, have no chest pain or breathlessness, and may be decades away from symptoms. Convincing these individuals to take preventative medications, change their diet or increase exercise can be challenging when they can't feel the problem.
The question driving this research is: could showing people visual evidence of disease in their own arteries motivate better self-care than traditional risk statistics?
What we explored
The research program investigated visual risk communication across multiple studies:
Does seeing imaging results change behaviour?
Researchers conducted a systematic review and meta-analysis examining whether showing patients cardiovascular images — including coronary artery calcium scans (showing plaque in heart arteries) and carotid ultrasound (showing plaque in neck arteries) — improved their cardiovascular risk factors compared to people who didn't see their results.
What's the long-term impact?
Through the CAUGHT-CAD trial, the team followed participants with intermediate cardiovascular risk for up to 10 years, repeatedly showing some participants images of calcium buildup in their coronary arteries while providing standard care to others. This tested whether ongoing visual reinforcement could sustain behaviour change over time.
Does it work for early heart failure?
Researchers also examined whether visual communication of cardiovascular imaging helped people with stage B heart failure (heart changes detected on imaging but no symptoms yet) better manage their condition through medication adherence and lifestyle modification.
What do GPs think?
The team explored general practitioners' perspectives on using visual risk communication in primary care practice, understanding the real-world challenges and opportunities for integrating this approach into routine preventive care.
What we found
Visual communication drives risk reduction
The meta-analysis revealed compelling evidence: when cardiovascular images were integrated into personalised risk discussions, patients achieved significantly better outcomes. Compared to individuals who didn't see their imaging results, those shown visual evidence of early disease experienced an absolute reduction of 0.91% in their 10-year Framingham risk score — a meaningful improvement in cardiovascular health.
Sustained behaviour change over time
The CAUGHT-CAD trial demonstrated that repeated visualisation of coronary artery calcium images over multiple years led to sustained improvements in cardiovascular risk factors. At three-year follow-up, participants who regularly viewed images of plaque in their own arteries showed significant reductions in cholesterol, blood pressure and calculated cardiovascular risk compared to the control group.
Ten-year follow-up data further confirmed that this approach can maintain long-term engagement with preventive care, suggesting that periodic visual reminders help people stay motivated to protect their heart health even when they feel well.
Improved medication adherence
Across studies involving people with subclinical atherosclerosis and early-stage heart failure, visual risk communication significantly improved adherence to preventive medications — particularly cholesterol-lowering statins. Seeing tangible evidence of disease made the abstract concept of "risk" feel real and urgent, motivating patients to consistently take medications they might otherwise discontinue.
Practical application in primary care
Insights from general practitioners revealed both enthusiasm and practical considerations for implementing visual risk communication. GPs recognised its potential to enhance patient engagement but identified needs for accessible imaging technology, appropriate patient selection and clear communication protocols to integrate this approach into busy primary care workflows.
Technical detail for researchers
Systematic review and meta-analysis
A comprehensive systematic review examined randomised controlled trials investigating visual communication of cardiovascular imaging results (coronary artery calcium scoring, carotid intima-media thickness, carotid plaque imaging) compared to standard risk communication without image disclosure.
Meta-analysis of included studies demonstrated that visual cardiovascular risk communication was associated with statistically significant improvements in cardiovascular risk factor profiles. The pooled analysis showed an absolute 0.91% reduction in 10-year Framingham risk score (95% CI: 0.43-1.39%, p<0.001) among participants who received visual feedback compared to those blinded to imaging results.
Secondary analyses examined specific risk factors including LDL cholesterol, systolic blood pressure, smoking cessation rates and statin initiation/adherence, with visual communication showing beneficial effects across multiple domains of cardiovascular risk modification.
Key publication
Review of strategies to improve adherence to lipid lowering therapy in the primary prevention of cardiovascular disease
Eur J Prev Cardiol 2025 Sep 22;32(13):1204–1215
CAUGHT-CAD trial: Long-term outcomes
The CAUGHT-CAD (Coronary Artery Calcium and Guideline-based High-intensity statin Therapy) trial was a randomised controlled trial enrolling asymptomatic individuals at intermediate cardiovascular risk (10–20% 10-year Framingham risk) with detectable coronary artery calcium (CAC score >0).
Participants randomised to the intervention arm received repeated visualisation of their coronary artery calcium images during follow-up consultations, integrated with personalised cardiovascular risk counselling and guideline-based statin therapy. Control participants received standard preventive care without image disclosure.
At three-year follow-up, the intervention group demonstrated significant reductions in LDL cholesterol, systolic blood pressure and calculated 10-year cardiovascular risk compared to controls. Medication adherence rates (measured via pharmacy dispensing data and self-report) were significantly higher in the visualisation group.
Ten-year follow-up analysis examined sustained behaviour change, cardiovascular event rates and ongoing medication persistence, providing insights into the durability of visual risk communication strategies in primary prevention cohorts.
Key publications
Influence of repeated plaque visualization on cardiovascular risk reduction after 3 years: a randomized controlled trial
Eur J Prev Cardiol 2024 32(7):596–605
Outcomes of repeated patient visualization of coronary artery calcium images in participants at intermediate cardiovascular risk: 10-year follow-up of the CAUGHT-CAD trial
Heart, Lung Circ 2025 34(4) S659
Implementation in subclinical disease and stage B heart failure
Subsequent implementation studies examined visual risk communication in populations with subclinical atherosclerosis (imaging evidence of plaque without symptoms) and stage B heart failure (structural heart changes without clinical heart failure symptoms).
These studies demonstrated that personalised cardiovascular imaging visualisation, integrated into routine clinical care pathways, significantly improved both risk factor control and adherence to guideline-directed medical therapy compared to standard risk communication approaches. Effect sizes were particularly pronounced for statin adherence and blood pressure management.
Qualitative components incorporating general practitioner perspectives explored barriers and facilitators to implementing visual risk communication in primary care settings, including considerations around imaging accessibility, consultation time constraints, patient health literacy requirements and integration with existing cardiovascular risk management protocols.
Findings support the feasibility and effectiveness of visual risk communication as an adjunct to standard preventive cardiology practice, with implications for clinical guideline development and healthcare delivery models.
Research team
Lead researcher
Principal Investigators
What this means for the future
This research challenges us to rethink how we communicate cardiovascular risk. For too long, prevention has relied on abstract statistics that many patients struggle to relate to their own lives. By demonstrating visually that evidence of early disease can motivate sustained behaviour change, this work opens new pathways for engaging people in their heart health before symptoms appear.
As imaging technology becomes more accessible and affordable, integrating visual risk communication into routine preventive care could help close the gap between knowing you're at risk and actually doing something about it. The implications extend beyond cardiovascular disease — this approach may inform how we communicate risk across many chronic conditions where early, asymptomatic changes can be detected.
When patients can see what's happening inside their own arteries, prevention becomes personal. And personal motivation drives lasting change.