CVD-Screening with Arm Resting

A study was done with the aim of determining whether it is viable to screen for CVD with resting or exercise ECG in asymptomatic adults at intermediate or high risk of CVD events.

Members of USPSTF involved in the study found that evidence was limited with regards to whether one should be tested for CVD with the arm resting or at an exercise. These recommendations are in line with 2018 recommendations by the task force.

CVD Risk Assessment

Clinical settings commonly use the resting ABI test to detect the presence or absence of PAD. It’s important to note that the results obtained are normally varied with regards to the kind of measurement protocol used. In this method, the systolic blood pressure at the ankle is divided by the brachial artery in a patient who lies down. If the ratio is not more than one (<0.9), an individual is said to be in the abnormal range of the scale.

There is little evidence to support the use of low ABI value as a surrogate marker for PAD practice as much as its use is rampant.

USPSTF analyzed existing evidence to determine whether the mortality rate could be reduced with the use of ABI to screen asymptomatic patients. From this examination, the task force concluded that the current evidence with respect to the balance of benefits and harms of screening for CVD was still limited.

“We are aware that ABI is a preferred diagnosis mechanism for people with PAD symptoms,” said Seth Landefeld, M.D and member of USPSTF. “However, we were interested in determining whether it could be relied on in identifying the risk of having a blocked vessel in the leg for individuals showing signs of PAD. As we speak, we have no much information to advocate for or refute the ABI screening mechanism.”

USPSTF published the final part of this recommendation on its website for public comment starting 16th Jan to 12th Feb.

No much positive recommendation

Most of the commenters asserted that there wasn’t enough positive recommendation from the task force with respect to patients facing an increased risk of developing PAD. This affects both older adults; patients with hypertension, diabetes or high levels of cholesterol.

A final part of the recommendation read that “screening for PAD in high-risk, asymptomatic need to be limited since there isn’t enough data to champion for or negate differential screening when it comes to patients at greater risk.”