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Routine Screening for Ischemic Heart Disease Risk Factors Doesn't Improve Clinical Outcomes — Physician’s First Watch

Medical News |
June 11, 2014

Routine Screening for Ischemic Heart Disease Risk Factors Doesn't Improve Clinical Outcomes

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Richard Saitz, MD, MPH, FACP, FASAM

A large randomized trial in BMJ casts doubt on the benefits of routine screening for ischemic heart disease in the general population.

Some 60,000 Danish adults were randomized to an intervention or control group. Intervention participants were offered screening (e.g., questionnaires, physical exams, lipid profiles), risk assessment, and lifestyle counseling up to four times over 5 years. Those with unhealthy habits (e.g., smoking) underwent individual lifestyle counseling at all visits; those at high risk for ischemic heart disease could also receive group counseling. Controls were unaware of an ongoing intervention.

Although intervention participants had significant improvements in lifestyle after 5 years, the 10-year incidence of ischemic heart disease, stroke, or total mortality did not differ significantly between the groups.

The authors conclude: "Systematic screening of the general population ... has, in this large randomized population-based study and in all previous similar studies, not been able to reduce the incidence of ischemic heart disease. Therefore, health checks with systematic screening and counseling cannot be recommended. Lifestyle counseling should continue in everyday practice but should not be implemented as a systematic program in the general population."

Reader Comments (2)

Soundararajan Murugan Physician, Internal Medicine, Malaysia, Sabah

Surprising but eye opener. Discourages practice of routine screening of a battery of investigations which may not henceforth be relevant at least until new evidences appear.

KOLLAR JOZEF Other, Cardiology, Slovakia

It is shockiíng notice, because up to this time was prefered screening as important method for prevention. It means thar science for medicne is radicaly change and we must count with it but several don ´t believe, that it may be so.

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