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Heart attack and stroke screening times should be more individual

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Posted April 29, 2019

Certain lifestyle choices and conditions can increase your risk of having a stroke or a heart attack. Of course, routine check-ups is one of the more reliable ways to reduce this risk. In fact, now scientists from UCL and the University of Helsinki say that as many as 1 in 10 heart attacks and strokes in England and Wales could be prevented if routine check-ups were better targeted.

In most cases following doctor’s recommendations is enough to significantly reduce the likelihood of having a heart attack or a stroke. Image credit: Sebastián LP via Wikimedia

Once people reach 40, they should be more concerned with the health of their heart and blood vessels. In routine checks medical professionals are checking systolic blood pressure, cholesterol profile, blood glucose, smoking status and many other different factors. In UK, those who are 40 or older can get checks every 5 years. Doctors then prescribe drugs or provide lifestyle recommendations.

However, now scientists say that this approach could be improved if the period between check-ups was not rigid, but instead was tailored to an individual’s level of risk. They estimate that this would prevent 5,000 heart attacks and strokes in England and Wales alone.

American Heart Association and the European Society of Cardiology both recommend 5 year check-ups. And it is a pretty good advice, but did you know that these 5 years are not based in research in any way? Scientists followed over 7,000 men and women for 22 years. Scientists found that those in the low-risk category took 9 years to become intermediate-low-risk, where they stayed for 7 years. However, just in 4 years 70% of intermediate-high-risk patients became high-risk and needed treatment. This shows that the progression of the risk is highly individual and should be addressed as such. Moreover, scientists ran simulations and found that tailored approach would not cost more.

Individualized screening intervals would make for a more effective system. Recommendations are already based on people’s condition – we know that one-size-fits-all approach is not the most effective. Because interventions would be more direct and individual, more deaths could be prevented. Professor Mika Kivimaki, senior author of the study, said: “Our findings are promising, but national guidelines are rarely changed based on one study. The benefits of individualised screening intervals should be further studied in a randomised control trial before changing the guidelines”.

Switching to a more individualized system would not be easy, however. It would require some planning and new guidelines. But every prevented deaths would be a reward in itself.

 

Source: UCL

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