The U.S. Preventive Services Task Force has released its final recommendation statement and evidence report on screening for peripheral artery disease and cardiovascular risk assessment with the ankle brachial index in adults.
The task force found that for adults with no symptoms of PAD, the evidence was not sufficient to determine whether using the ABI test to screen for PAD and predict risk of cardiovascular disease is beneficial. Therefore, the group issued an I statement, meaning evidence is insufficient to make a definitive recommendation.
Under terms of the Affordable Care Act, preventive services that receive an A or B recommendation must be covered by health plans with no cost-sharing.
Cardiovascular disease, including heart disease and stroke, is the leading killer of both men and women in the U.S., according to background information in the statement. For some people, PAD, which causes reduced blood flow in the legs, can go hand-in-hand with cardiovascular disease. The ABI test, which compares blood pressure in the ankle with blood pressure in the arm, is used to detect whether a person has PAD.
As clinicians, we know that addressing the underlying risk factors can help to prevent heart attacks and strokes, task force member Kirsten Bibbins-Domingo, MD, PhD, said in a news release. Although the evidence is not yet clear on using the ABI test to evaluate cardiovascular disease risk in people with no symptoms, there are many other steps we know work to help to prevent cardiovascular disease including eating a healthy diet and maintaining a healthy weight, exercising regularly and not smoking.
Even though it is not clear if the ABI helps healthcare professionals make treatment decisions, there are many thing clinicians can do to help their patients reduce their chances of heart attacks and strokes, said USPSTF co-vice chair Albert Siu, MD, MSPH. The USPSTF recommends screening for and managing high blood pressure, high blood cholesterol and diabetes and screening for tobacco use and providing cessation support.
The recommendation does not apply to people who are having symptoms of PAD, such as leg pain when walking that is relieved with rest. People with symptoms should see a health professional and should receive appropriate diagnostic testing and therapy.
Before finalizing the recommendation, the USPSTF posted a draft version for public comment earlier this year.
Statement and supporting links: www.uspreventiveservicestaskforce.org/uspstf/uspspard.htm.