Related Experiment Video
Updated: Aug 12, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Screening family members at high risk for coronary disease. Why isn't it done?
1Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14623, USA.
Insights
Physicians rarely screen family members of patients with early cardiovascular disease (CVD) for risk factors, despite national guidelines. This study highlights a significant gap in preventive care for hereditary cardiac conditions.
Area of Science:
- Cardiology
- Preventive Medicine
- Genetics
Background:
- National guidelines recommend screening family members of patients with early cardiovascular disease (CVD) for coronary risk factors.
- Physician and patient compliance with these recommendations is not well-studied.
- The American College of Cardiology Evaluation of Preventive Therapeutics (ACCEPT) study aimed to assess screening practices.
Purpose of the Study:
- To determine if physicians screen first-degree relatives of patients with early CVD.
- To evaluate compliance with National Cholesterol Education Program recommendations.
Main Methods:
- The ACCEPT study surveyed 5553 patients undergoing procedures for CVD or experiencing acute events.
- Screening of first-degree relatives was assessed via self-report at 6-month follow-up interviews.
- Data were collected from 53 hospitals across the United States.
Main Results:
- Less than 1% of medical records showed physician plans for family screening.
- Only 17.8% of patients had their families screened within 6 months of a cardiovascular event.
- Factors associated with successful screening included patient education, high cholesterol, widowhood, non-smoking status, and being Black.
Conclusions:
- U.S. physicians largely do not adhere to national recommendations for screening families of high-risk patients.
- Physicians may not be prepared to integrate genetic factors into CVD treatment despite advances in genomics.
Background:
The National Cholesterol Education Program strongly recommends screening family members of patients with early cardiovascular disease (CVD) for coronary risk factors, but the physician and patient compliance with this recommendation has not been extensively studied. The American College of Cardiology Evaluation of Preventive Therapeutics (ACCEPT) study, a national survey conducted in 1996-1997, determined if physicians were screening first-degree relatives of patients with early CVD.
Setting/Participants:
The ACCEPT study included 5553 patients with either their first bypass surgery, first angioplasty, an acute myocardial infarction, or myocardia ischemia, admitted to 53 hospitals throughout the United States.
Main Outcome Measure:
Self-reported screening of first-degree relatives obtained by interview follow-up 6 months after event.
Results:
Less than 1% of inpatient medical records contained a discharge plan by the physician recommending screening family members of patients younger than age 55. Only 17.8% of these patients had their family screened within 6 months of their cardiovascular event, while only 19.6% with a recognized family history of premature coronary artery disease had their family screened. The only factors that were significant (p<0. 05) predictors of successful family screening were education (19.4%), having high cholesterol (16.4%), being widowed (18.1%), not smoking (16.4%), and being black (20.5%).
Conclusions:
U.S. physicians do not appear to follow national recommendations for the screening of family members of their high-risk patients. These data also suggest that physicians are not ready to use and exploit known genetic factors in treating CVD even as the human genome data become available for clinical use.
More Related Videos
Related Concept Videos
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:29Assessment of the Cardiovascular System II: Inspection
Head and Neck
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease IV: Preventive Measures
01:27Coronary Artery Disease V: Interprofessional Care