Screening for intermediate risk factors for coronary heart disease: systematic evidence synthesis
Helfand M, Buckley D, Fleming C, Fu R, Freeman M, Humphrey L, Rogers K, Walker M
Record ID 32011000570
English
Authors' objectives:
In the United States, coronary heart disease and cardiovascular disease account for nearly 40% of deaths each year. An individual’s estimated risk for coronary heart disease events, often based on factors incorporated into the Framingham risk score, guides the intensity of risk reduction interventions. We conducted a systematic review of epidemiologic studies to help the U.S. Preventive Services Task Force determine which, if any, of 9 additional risk factors should be considered for incorporation into guidelines for coronary and cardiovascular risk assessment in primary care.
Authors' recommendations:
Several emerging risk factors provided independent information about coronary heart disease risk, but for most there were limitations in the evidence base. Across all of the criteria listed in the table, C-reactive and electron beam computed tomography scan had the strongest evidence for an independent effect in intermediate-risk individuals, and both reclassify some individuals as high-risk. However, data on electron beam computed tomography are relatively sparse, the technique is more expensive, and its potential harms require more investigation. Periodontal disease, carotid intima media thickness, homocysteine, and lipoprotein(a) probably provide independent information about coronary heart disease risk, but data about their prevalence and impact when added to Framingham risk score in intermediate-risk individuals are limited.
Details
Project Status:
Completed
URL for project:
http://www.ncbi.nlm.nih.gov/books/NBK35208/
Year Published:
2009
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Mass Screening
- Risk Factors
Contact
Organisation Name:
Agency for Healthcare Research and Quality
Contact Address:
Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name:
martin.erlichman@ahrq.hhs.gov
Contact Email:
martin.erlichman@ahrq.hhs.gov
Copyright:
Agency for Healthcare Research and Quality (AHRQ)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.