title: Atherosclerotic cardiovascular disease screening in adults: American College Of Preventive Medicine position statement on preventive practice.
abstract: BACKGROUND
  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.
  
  
  METHODS
  Current guidelines and studies pertaining to CHD, CAS, PAD, and AAA screening in the adult population were reviewed.
  
  
  RESULTS
  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.
authors.affiliation: Departments of Preventive and Internal Medicine, Griffin Hospital, Derby, Connecticut, USA.
authors.forename: Lionel S
authors.initials: LS
authors.lastname: Lim
authors.forename: Nowreen
authors.initials: N
authors.lastname: Haq
authors.forename: Shamail
authors.initials: S
authors.lastname: Mahmood
authors.forename: Laura
authors.initials: L
authors.lastname: Hoeksema
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011314:Preventive Health Services / Q000379:methods*; D012307:Risk Factors; D012737:Sex Factors; D014481:United States