WASHINGTON, D.C. – January 16, 2018 – Cardiovascular disease (CVD), which can lead to heart attack and stroke, is the leading cause of death for adults in the United States. The U.S. Preventive Services Task Force (Task Force) today posted two draft recommendation statements and draft evidence reviews related to CVD: screening for peripheral artery disease (PAD) and CVD risk assessment with the ankle-brachial index (ABI) and risk assessment for CVD with nontraditional risk factors.

Screening for PAD and CVD Risk Assessment With the ABI PAD is a condition where blood flow to the limbs, especially the legs, is reduced due to a narrowing and hardening of the arteries. PAD can cause leg and foot pain when resting or walking, poor wound healing, tissue damage, and loss of limbs. People with PAD are also more likely to have a CVD event, such as heart attack and stroke. People with PAD can also have no symptoms. The Task Force looked at the current evidence to determine if screening people without signs or symptoms of PAD with the ABI can help prevent heart attack, stroke, or PAD complications. Based on its review, the Task Force found that there is insufficient evidence to recommend for or against screening for PAD and CVD risk assessment with the ABI in people without signs or symptoms. This is an I statement.

“The ABI is a way of taking blood pressure using readings from both the ankle and the arm to determine risk of blocked vessels in the leg,” says Task Force member Alex Krist, M.D., M.P.H. “For people with symptoms of PAD, the ABI can be used for diagnosis. However, more evidence is needed to determine if the ABI can accurately identify PAD in people without signs or symptoms.”
This draft recommendation statement updates and is consistent with the 2013 recommendation statement. CVD Risk Assessment With Nontraditional Risk Factors Separately, the Task Force reviewed whether adding three nontraditional risk factors to traditional risk
models can effectively improve risk assessment for CVD. Traditional risk factors are based on age, race/ethnicity, sex, diabetes, smoking status, cholesterol levels, and blood pressure. The Task Force looked at the evidence for three nontraditional risk factors: the ABI, high-sensitivity C-reactive protein (hsCRP) (which measures the amount of a certain protein in the blood), and coronary artery calcification (CAC) score (which measures the amount of calcium buildup inside the coronary arteries). The Task Force found that there is not enough evidence to recommend for or against assessing CVD risk in adults with these nontraditional risk factors, along with traditional risk factors, to help prevent heart attack or stroke. This is an I statement.

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