Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Effectiveness of Personalized Stroke Risk Communication - A Pilot Randomized Controlled Trial
Brief Summary: The goal of this research is to improve communication to Veterans. The investigators want to improve how doctors and nurses talk to patients about the risk of heart attack and stroke. The investigators will give everyone in the study information about the risk for heart attack or stroke. The investigators will also provide information on how to reduce this risk. This information will be given in one of two ways. The investigators want to see which way of giving information works better for veterans. The investigators also want to assess the impact of personalized stroke risk communication to patients at risk for stroke on patient knowledge, beliefs, and preferences for risk reduction behaviors and evaluate the impact of personalized risk communication on medication adherence and blood pressure. The investigators plan to enroll approximately 100 veterans for this study. All veterans will be from the Durham VA Primary Care Clinics. The investigators will ask everyone to be in the study for 3 months.


Options:
A: Inclusion Criteria:

* Enrolled in a Durham VA Primary Care Clinic for at least one year
* Age ≥ 55 years old
* Diagnosis ICD 401.0, 401.1, or 401.9 on outpatient electronic encounter forms in the prior year
* Received a prescription for hypertensive medication (ACE inhibitors, beta blockers, calcium channel blockers, diuretics, alpha1 blockers, and/or central alpha2 agonists) in the previous year
* Inadequate BP control based on an average of prior 12-month clinic BP measurements
* Have a baseline EKG within the last 5 years to evaluate the presence of left ventricular hypertrophy.

Exclusion Criteria:

* Hospitalized at the DVAMC for a myocardial infarction (MI), coronary artery revascularization, or diagnosis of metastatic cancer in the past 6 months
* Prior history of stroke
* Active diagnosis of psychosis or dementia documented in medical record
* Participating in another chronic disease self-management study
* Resident of a nursing home
* Does not have access to a telephone
* Refusal to provide informed consent
B: Inclusion Criteria:

- Active smokers over 40 years and more than 10 pack-years

Exclusion Criteria:

* Previous diagnosis of respiratory disease (asthma, COPD, interstitial lung disease) that cause alteration of spirometric pattern.
* Patients with limitations in performing spirometry
* Age greater than 80 years
* Institutionalized patients
* Patients with a life expectancy less than 1 year
* Spirometry in the past 2 years
C: Inclusion Criteria:

* Aged 20-70 years
* Smoking more than 10 cigarettes daily

Exclusion Criteria:

* Aged under 20 years or over 70 years
* Smoking less than 10 cigarettes daily
* History of major depression and other psychiatric conditions, dementias and serious or terminal illness (cancers etc.).
* Patients on warfarin would be excluded due to interactions between warfarin and varenicline as varenicline will be used as the modern treatment of choice for smoking cessation.

Patients who did not wish to have a genetic test would be referred to the practice nurse for smoking cessation.
D: Inclusion Criteria:

* Adult smoker subjects aged between 35 and 70 years

Exclusion Criteria:

* Previous antecedents of any respiratory disease
* Suffering of any chronic or terminal disorder
* Counterindication to undertake spirometry or that may hinder the performance of the spirometry test

Answer: A