Evidence not strong enough yet on nine heart disease screening tests


In a new statement, the US Preventive Services Task Force analyzed the evidence for nine nontraditional ways to screen people with no history of coronary artery disease. And the panel concluded that the evidence isn't strong enough yet to be able to judge the balance of benefits and harms with the following:

• high-sensitivity C-reactive protein (hs-CRP)
• ankle-brachial index (ABI)
• leukocyte count
• fasting blood glucose level
• periodontal disease
• carotid intima-media thickness (carotid IMT)
• coronary artery calcification (CAC) score on electron-beam computed tomography
• homocysteine level
• lipoprotein(a) level.

We'll see how widely this is reported by mainstream news organizations - many of whom have already sung the praises of some of these, especially the C-reactive protein test and coronary calcium CT scans.

The USPSTF states:

Little evidence is available to determine the harms of using nontraditional risk factors in screening. Potential harms include lifelong use of medications without proven benefit and psychological and other harms from being misclassified in a higher risk category. ... Adding nontraditional risk factors to coronary heart disease assessment would require additional patient and clinical staff time and effort. Routinely screening with nontraditional risk factors could result in lost opportunities to provide other important health services of proven benefit.


Are you saying that we should maintain our mediocre health practices and let CV disease claim half of America? Is it responsible to dismiss all the tools currently in use because they aren't good enough? Cholesterol screening (which is currently part of the standard of care) is still less effective than most of these mentioned tests for identifying those at risk of heart disease. But, because its protocol, it is beyond reproach. And it seems beyond supplementation. Half of America will die of a heart attack or stroke and we can't seem to agree on how to preventatively diagnose?
Good luck, because this disease will statistically kill you or your significant other.


It is my stated policy on this blog not to post product pitches.

I see that you represent a company that promotes at least one of these tests, so your commercial interests should be noted.

I’m not “saying” anything.

I posted the latest evidence-based review of the literature by the leading independent organization in this country that makes preventive health recommendations.


Are you saying you know more than they do? Sounds like your argument is with them and with the evidence, not with me.

About this Entry

This page contains a single entry by Gary Schwitzer published on October 6, 2009 4:14 PM.

Family physicians have a Coke (and a 6-figure deal) and a smile was the previous entry in this blog.

Where are the mainstream news media on USPSTF coronary risk test story? is the next entry in this blog.

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