11 Feb USPSTF: Should Asymptomatic Patients Be Screened for Coronary Artery Disease?
MedicalResearch.com Interview with:
Dr. Caughey
Aaron B. Caughey, M.D., M.P.P., M.P.H., Ph.D.
Professor and Chair
Department of Obstetrics and Gynecolog
Associate dean for Women’s Health Research and Policy
Oregon Health & Science University Portland, OR.
Founder and Chair
Centers for Disease Control and Prevention–funded Oregon Perinatal Collaborative
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Stroke is a leading cause of death and disability in the United States and can be devastating to those affected. One of many risk factors for stroke is carotid artery stenosis (CAS), which is the narrowing of the arteries that run along the sides of the neck and supply blood to the brain.
The Task Force wants to help prevent people from having a stroke, but evidence shows that screening for CAS in people without symptoms does not help prevent strokes and can actually lead to harmful events such as stroke, heart attack, or death. Since the harms of screening greatly outweigh the benefits, the Task Force continues to recommend against screening for CAS among adults who do not have any signs or symptoms of a blocked artery in the neck.
MedicalResearch.com: What should readers take away from your report?
Response: The best way to prevent a stroke and other cardiovascular diseases is to focus on the things we know work, including not smoking, maintaining a healthy weight, being physically active, eating a healthy diet, and controlling high blood pressure and cholesterol.
Anyone with concerns about their risk for a stroke or with a history of stroke should talk with their doctor to determine the best plan for them.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: The Task Force is calling on the research community to help fill critical research gaps on this important topic, including developing tools to help identify who is at high risk for carotid artery stenosis, and determining which of the adults who do have CAS are more likely to have a stroke. More research is also needed to better understand the harms from surgeries that treat CAS, and to compare surgeries to treat CAS with current standard medical therapies such as lifestyle interventions and medications
MedicalResearch.com: Is there anything else you would like to add?
Response: While CAS is uncommon, the risk of getting it increases with age, and it can lead to strokes. Other risk factors for CAS include many of the same traditional risk factors for cardiovascular disease, including a history of smoking, high blood pressure, high cholesterol, diabetes, or male sex. Those with a history of heart disease are also at increased risk of carotid artery stenosis.
If someone is experiencing signs of a stroke, which include slurred speech or an inability to speak or understand speech; weakness, numbness, or tingling in your face, arm, or leg; confusion; or loss of consciousness, call 911 or call/see a doctor immediately.
Citations:
- Guirguis-Blake JM, Webber EM, Coppola EL. Screening for Asymptomatic Carotid Artery Stenosis in the General Population: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2021;325(5):487–489. doi:10.1001/jama.2020.20364
USPSTF Recommendation: Screening for Asymptomatic Carotid Artery Stenosis
US Preventive Services Task Force; Alex H. Krist, MD, MPH; Karina W. Davidson, PhD, MASc; Carol M. Mangione, MD, MSPH; Michael J. Barry, MD; Michael Cabana, MD, MA, MPH; Aaron B. Caughey, MD, PhD; Katrina Donahue, MD, MPH; Chyke A. Doubeni, MD, MPH; John W. Epling Jr, MD, MSEd; Martha Kubik, PhD, RN; Gbenga Ogedegbe, MD, MPH; Lori Pbert, PhD; Michael Silverstein, MD, MPH; Melissa A. Simon, MD, MPH; Chien-Wen Tseng, MD, MPH, MSEE; John B. Wong, MD
2. JAMA Patient Page
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Last Updated on February 11, 2021 by Marie Benz MD FAAD