Blanka Ehrenberger

Background/Objectives: Effective cardiovascular prevention requires improved risk perception and appropriate communication strategies that support cost-effective interventions. This study evaluated one-year changes in cardiovascular risk estimation accuracy and examined associations between communication strategies, accuracy, and health outcomes. Methods: We analyzed 200 participants (mean age: 56.06 ± 6.26; 32.2% male) in a population-based study conducted in Hungary. Cardiovascular risk was calculated using the Framingham Risk Score based on laboratory and anthropometric measures, and subjective risk perception was assessed and categorized as realistic, optimistic, or pessimistic relative to objective risk. All participants received written risk feedback, while subgroups additionally participated in individual or group-based risk communication. Results: After 12 months, the proportion of participants with accurate risk perception increased from 39.0% to 50.5% (p = 0.012), accompanied by a significant reduction in pessimistic estimations (p = 0.013). We could not observe significant differences in estimation accuracy between communication strategies. The written-only communication group showed a significant decrease in cardiovascular risk factors (weight (p = 0.014), BMI (p = 0.042), blood pressure (p = 0.035), and LDL levels (p = 0.001)). No significant differences were found in health outcomes between risk communication groups. Conclusions: These results demonstrate that even written-only communication may be an effective way to improve cardiovascular health outcomes, possibly by correcting risk perception gaps, suggesting that cost-effective, low-intensity communication strategies may be sufficient to support primary prevention efforts.

Introduction: Self-rated health (SRH) predicts morbidity and mortality; however, its long-term trajectories and associations with psychological wellbeing (PWB), health behaviors, and cardiovascular risk remain understudied in Central and Eastern Europe. Aim: To describe 10-year changes in cardiovascular risk, health behaviors, PWB, and SRH, and to examine how SRH relates to PWB, health behaviors, and cardiovascular risk in a non-clinical Hungarian adult sample. Methods: Adults from Budakalász who participated in a cardiovascular screening in 2012 were invited to follow up in 2023. The analysis included 170 participants aged 45–65 years without major cardiovascular events. SRH was assessed with a single global item. Anthropometric and laboratory measures, FINDRISK and Framingham risk scores, health behaviors, and a fouritem PWB score derived from the Short Form (36) Health Survey (SF-36)were included. Non-parametric tests, independent sample t-tests, and Spearman correlations were applied. Results: Over the 10-year period, SRH showed a modest overall decline, with approximately one-quarter of participants reporting deteriorated SRH, more than half remaining stable, and a minority improving. SRH trajectories were not consistently associated with changes in PWB, cardiovascular risk, or health behaviors. Cross-sectionally, SRH was moderately correlated with PWB but only weakly related to health behaviors. Anthropometric data and cardiovascular risk scores increased, whereas fasting glucose, HbA1c%, and fruit and vegetable consumption improved, and physical activity shifted toward lower intensity. Conclusions: SRH was closely aligned with PWB over 10 years but largely decoupled from objective cardiovascular risk and health behaviors, supporting SRH as a psychologically grounded subjective health construct relevant for cardiovascular prevention.

The success of heart transplantation (HTX) is profoundly influenced by various psychosocial factors, underscoring the necessity of a multidisciplinary approach throughout the patient’s journey. Relevant psychosocial factors, such as adherence to complex post-transplant regimens, psychological status (e.g., risk of anxiety, depression), and the long-term goal of social and professional reintegration (return to work), significantly impact post-transplant outcomes. Current guidelines strongly recommend a multidisciplinary team, including psychologists, social workers, and other specialized non-medical professionals, as their involvement is associated with better quality of care and improved long-term outcomes. This paper synthesizes the evidence underlying psychologically informed heart transplantation care, highlighting the integration of fundamental psychological principles into routine medical practice. This approach features a genuine transdisciplinary collaboration, extending beyond traditional medical care. The implementation framework includes adopting the World Health Organization’s Multidimensional Adherence Model, tailored to the HTX population, and a spectrum approach to mental health, facilitating unified assessment and care aligned with the competencies of different team members. Furthermore, the collaborative team is trained in Low-Intensity Psychological Interventions, which are simple and effective; these can be embedded into routine clinical pathways by various healthcare staff to quickly address anxiety, adherence, and suboptimal health behaviors. By applying the concept of psychologically informed care, HTX centers can facilitate the genuine integration of interdisciplinary collaboration, ensuring comprehensive physical and psychosocial support for recipients.

Background/Objectives: Psychosocial factors (e.g., adherence, substance use) contribute to increased morbidity and mortality after heart transplantation. We investigated alcohol consumption patterns and their associations with psychosocial factors in adults, who underwent heart transplantation surgery (HTX recipients). Methods: Our cross-sectional study was conducted at the Semmelweis University Heart and Vascular Centre between 2023 and 2025. In total, 201 HTX recipients (75.6% male, mean age: 56.33 ± 11.46 years) completed the Alcohol Use Disorders Identification Test (AUDIT), Brief Health Literacy Screening Tool (BRIEF), Medication Adherence Report Scale (MARS-5) modified to immunosuppressive medication, and 9-item Beck Depression Inventory (BDI-9). Statistical analysis included Pearson’s correlation tests and Multivariate Regression Analyses. Results: The AUDIT had a higher proportion of non-evaluable responses than other questionnaires (AUDIT 19.9% vs. 5.5–9%), with 41.0% of the participants abstinent, 54.7% low-risk, 4.3% medium-risk, and 6.5% at-risk drinkers. AUDIT correlated negatively with MARS-5 (r = −0.326; p = 0.000) and positively with BDI-9 (r = 0.208; p = 0.010). At-risk drinking was associated with a lower MARS-5 (r = −0.231; p = 0.002). Multivariate regression models significantly predicted the AUDIT (F = 5.106; p < 0.001, R² = 0.216) and AUDIT-C (F = 3.804; p = 0.002; R² = 0.146), with sex and adherence as independent predictors. Conclusions: The high proportion of non-evaluable AUDIT responses suggests limitations in multi-questionnaire use but does not diminish its clinical relevance. The presence of 6.5% at-risk and 4.3% medium-risk drinkers highlights the relevance of consumption pattern screening, beyond diagnosing alcohol use disorder. Associations between AUDIT, MARS-5, and BDI-9 emphasize the necessity for multidisciplinary care.