The Benefits of Ultrasound Screening in Key Cardiovascular Disease Areas

At the 2014 World Congress of the International Union of Angiology (IUA), held in Sydney, Australia, new evidence was presented in support of the benefits of ultrasound screening in key cardiovascular disease areas—abdominal aortic aneurysm (AAA), atrial fibrillation (AF), carotid artery disease and chronic kidney disease (CKD).

Globally, cardiovascular diseases are the number one cause of death, annually1. Each year, 20 million people in middle and old age die due to vascular disease2. Cardiovascular screening allows risk factors that have gone unnoticed for years to be identified, giving doctors the information necessary to provide the best treatment for their at-risk patients3. Discovering risk early and preventively treating the disease before it happens can significantly reduce the harms of cardiovascular disease.

Research presented by world opinion leaders, which includes Life Line Screening Scientific Advisors and Life Line Screening UK’s Clinical Director, Dr. Mohsen Chabok, at the 2014 IUA conference shows that early identification of asymptomatic individuals who are at risk for cardiovascular disease can reduce morbidity and mortality from myocardial infarction (MI) and stroke by 50%, when the at-risk individuals are targeted for aggressive risk factor modification. The research also shows that a significant proportion of the population studied have early signs of vascular disease.

“We are very excited about our collaboration with Life Line Screening,” said Mr. Richard Bulbulia, a consultant Vascular Surgeon at Oxford University, who is presenting a paper emphasizing the benefits of really large epidemiological studies in helping to clarify the importance of modifiable risk factors.

Professor Andrew Nicolaides, MS, FRCS, FRSCE, PhD (Hon), explains:

“Atherosclerotic arterial disease (deposits of cholesterol in the arteries), which is responsible for heart attacks and strokes, develops slowly and silently for many years before it becomes manifest as disease. Its detection and silent progression can be recorded accurately with ultrasound scans. The presence of such silent deposits places an individual at high risk and in need of prevention. Prevention with modern medical therapy can reduce the risk of heart attacks and strokes by 50%.”

The U.K. data provides irrefutable evidence for the value and benefits of ultrasound screening. Patients with significant asymptomatic carotid artery disease are considered at high risk for cardiovascular events in the next 10 years, and all of them need to be on optimal medical therapy, including an Aspirin regimen, blood pressure lowering medication and cholesterol lowering medication. The data suggests that 75% of the at-risk population were not on Aspirin and more than 60% were not on Statins or blood pressure drugs.

 

Why We Need Ultrasound Screening

The Benefits of Ultrasound Screening

Click the image above to view the full infographic.

Carotid artery disease identified using ultrasound screening may be a predictor of stroke or heart attack. Identifying subclinical atherosclerosis disease early allows patients to change their lifestyle behavior to reduce risk and allows doctors to instigate appropriate therapy.

The absence of risk factors does not guarantee that a person will not die from a heart attack. In fact, 1 in 3 people who develop a myocardial infarction (MI) will not have any of the conventional risk factors, which include smoking, unhealthy diet, obesity, physical inactivity, high blood pressure, diabetes and raised lipids4.

Similarly, 80% – 85% of strokes occur without warning5 in asymptomatic patients, so they can only be significantly reduced by finding and treating the disease before it happens.

Research shows that the lack of symptoms does not necessarily mean a person is healthy; they may simply be pre-symptomatic. Using ultrasound screening to identify pre-clinical disease can better inform future risk and help patients avoid complications such as renal failure and diabetes. More accurate diagnosis allows for more targeted treatment.

Evidence Shows Ultrasound Screening Works

Research supports the wider use of ultrasound screening in the community to detect early signs of vascular disease. The results of a recent survey among physicians in the U.S. clearly demonstrate overwhelming support for preventive cardiovascular ultrasound screening:

The following evidence from the research presented at the 2014 IUA shows the benefits of ultrasound screening:

  •  Ultrasound screenings that show patients real-time images of atherosclerotic deposits in their arteries is a powerful motivational tool to prompt lifestyle modifications and ensure compliance to treatment, which can prevent cardiovascular disease6.
  •  A significant proportion of the population have early signs of vascular disease that is identifiable by ultrasound screening in the community. The results from private health screening programs in Melbourne and Sydney, Australia, indicate the prevalence of significant carotid vessel disease was 1.7%. The prevalence of AAA was 2%, and 0.05% had a large life-threatening aneurysm that carries more than 20% risk of rupture.
  •  New research identifies sub-groups of women that are at significant risk of developing aortic aneurysms, and therefore older women may benefit from ultrasound screening to prevent death from AAA. Women over age 80 and women ages 70-79 who have 2 or more cardiovascular disease risk factors should have an ultrasound screening to check for AAA.
  •  A simple ultrasound screening test may slow the rise of chronic kidney disease (CKD). Screening for kidney function in patients with subclinical cardiovascular disease may identify patients at risk of developing CKD and allow early intervention to delay or avoid the need for costly dialysis. Patients with asymptomatic carotid artery disease are at 200% greater risk of developing CKD.
  •  A single ECG to screen for asymptomatic atrial fibrillation (AF) in people aged 65 years or older would be likely to detect 1.4% of people with asymptomatic AF in the general population. Screening for asymptomatic AF could be a cost-effective way to reduce the risk of stroke and premature death.

 

Click here to view our video and image gallery from IUA 2014 >>

 

In a rapidly evolving global health landscape, where chronic disease is rampant and cardiovascular conditions are the number 1 cause of death, we cannot afford to ignore the growing body of evidence that points to early detection of disease as a key factor in saving lives. The benefits of ultrasound screening to prevent cardiovascular diseases clearly outweigh the costs.

____________

  1. Cardiovascular diseases (CVDs) Fact Sheet – No. 317 (2013) – [URL]
  2. Cardiovascular diseases (CVDs) Fact Sheet – No. 317 (2013) – [URL]
  3. Screening for cardiovascular risk. Nicolaides, A. Br J Cardiol. (2010)
  4. The Prospective Cardiovascular Münster (PROCAM) study: prevalence of hyperlipidemia in persons with hypertension and/or diabetes mellitus and the relationship to coronary heart disease. Assmann G1, Schulte H. Am Heart J. (1988)
  5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906182/ (Accessed 14 August, 2014)
  6. Screening for cardiovascular risk. Nicolaides, A. Br J Cardiol. (2010)