USPSTF: Evidence Lacking for Nontraditional CVD Risk Factors

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Insufficient evidence for adding to traditional CVD risk assessment in asymptomatic adults.
Insufficient evidence for adding to traditional CVD risk assessment in asymptomatic adults.

(HealthDay News) -- The US Preventive Services Task Force concludes that there is currently insufficient evidence to assess the benefits and harms of adding nontraditional risk factors to traditional cardiovascular disease (CVD) risk assessment in asymptomatic adults. These findings form the basis for a final recommendation statement published online in the Journal of the American Medical Association.

Jennifer S. Lin, MD, from Kaiser Permanente Research Affiliates in Portland, Ore., and colleagues reviewed the evidence on the benefits and harms of the ankle-brachial index (ABI), high-sensitivity C-reactive protein (hsCRP) level, and coronary artery calcium (CAC) score in CVD risk assessment.

The researchers found adequate evidence that the addition of the ABI, hsCRP, or CAC score could make small improvements in both discrimination and reclassification, with variation in the magnitude and consistency of improvement. The evidence was insufficient to assess whether treatment decisions guided by these scores, in addition to traditional risk factors, could reduce incidence of cardiovascular events or mortality. Based on these findings, the Task Force concluded that the evidence is currently inadequate for assessing the balance of benefits and harms of adding these nontraditional risk factors to the traditional risk assessment of CVD in asymptomatic adults (I statement).

"More research is needed to know if adding these 3 tests for nontraditional risk factors to CVD risk assessment can help improve our ability to prevent heart attack or stroke," Task Force member Michael Barry, MD, said in a statement.

References

Risk Assessment for Cardiovascular Disease With Nontraditional Risk Factors. US Preventive Services Task Force Recommendation Statement. JAMA. Published online July 10, 2018. doi:10.1001/jama.2018.8359

Lin JS, Evans CV, Johnson E, et al. Nontraditional Risk Factors in Cardiovascular. JAMA. Published online July 10, 2018. doi:10.1001/jama.2018.4242

Wilkins JT, Lloyd-Jones DM. USPSTF Recommendations for Assessment of Cardiovascular Risk With Nontraditional Risk Factors. Finding the Right Tests for the Right Patients. JAMA. Published online July 10, 2018. doi:10.1001/jama.2018.9346

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