sábado, 25 de febrero de 2012

National Guideline Clearinghouse | Atherosclerotic cardiovascular disease screening in adults: American College of Preventive Medicine position statement on preventive practice.

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National Guideline Clearinghouse | Atherosclerotic cardiovascular disease screening in adults: American College of Preventive Medicine position statement on preventive practice.: - Enviado mediante la barra Google

Guideline Title

Atherosclerotic cardiovascular disease screening in adults: American College of Preventive Medicine position statement on preventive practice.

Bibliographic Source(s)

Lim LS, Haq N, Mahmood S, Hoeksema L, ACPM Prevention Practice Committee, American College of Preventive Medicine. Atherosclerotic cardiovascular disease screening in adults: American College of Preventive Medicine position statement on preventive practice. Am J Prev Med 2011 Mar;40(3):381.e1-10. [55 references] PubMed External Web Site Policy

Guideline Status

This is the current release of the guideline.

Am J Prev Med. 2011 Mar;40(3):381.e1-10.

Atherosclerotic cardiovascular disease screening in adults: American College Of Preventive Medicine position statement on preventive practice.

Lim LS, Haq N, Mahmood S, Hoeksema L; ACPM Prevention Practice Committee; American College of Preventive Medicine.

Collaborators (5)

Source

Departments of Preventive and Internal Medicine, Griffin Hospital, Derby, Connecticut, USA.

Abstract

CONTEXT:

Atherosclerotic cardiovascular diseases, including coronary heart disease (CHD), carotid artery stenosis (CAS), peripheral artery disease (PAD), and abdominal aortic aneurysm (AAA), affect millions of U.S. adults and are leading causes of morbidity and mortality. There is some uncertainty regarding the utility of certain screening tests for prevention of cardiovascular morbidity and mortality.

EVIDENCE ACQUISITION:

Current guidelines and studies pertaining to CHD, CAS, PAD, and AAA screening in the adult population were reviewed.

EVIDENCE SYNTHESIS:

CHD risk can be estimated by the Framingham Risk Score (FRS), which is valuable in identifying high-risk asymptomatic adults who may benefit from preventive treatments. There is moderate certainty that the benefits of screening do not outweigh the harms for individuals with asymptomatic CAS. The potential harms associated with routine PAD screening in asymptomatic adults are also likely to exceed benefits. Ultrasonography is a safe, noninvasive, and reliable screening test used to identify AAAs for treatment in men aged >65 years who have ever smoked.

CONCLUSIONS:

American College of Preventive Medicine (ACPM) recommends CHD risk assessment using the FRS to guide risk-based therapy. ACPM does not recommend routine screening of the general adult population using electrocardiogram, exercise-stress testing, computed tomography scanning, ankle-brachial index, carotid intima medial thickness, or emerging risk factors, including high-sensitivity C-reactive protein (hs-CRP). ACPM does not recommend routine screening of the general adult population for CAS or PAD. ACPM recommends one-time AAA screening in men aged 65-75 years who have ever smoked. Routine AAA screening in women is not recommended.
Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.