Related Experiment Videos
[The screening for asymptomatic vascular disease and risk factors in high risk patients: current practice]
P C Simons1, Y van der Graaf, J D Banga
1Academisch Ziekenhuis, Utrecht.
Insights
Patients referred for vascular disease or cardiovascular risk factors are rarely screened for asymptomatic conditions. This study highlights infrequent screening for macrovascular disease and associated risk factors in clinical practice.
Area of Science:
- Vascular Medicine
- Cardiovascular Disease Screening
- Preventive Cardiology
Context:
- Assessment of current practices in screening for asymptomatic vascular disease.
- Focus on patients referred with existing vascular disease or cardiovascular risk factors.
- Retrospective study conducted at a University Hospital in the Netherlands.
Purpose:
- To evaluate the frequency and consistency of screening for asymptomatic vascular disease and its risk factors.
- To identify current gaps in diagnostic testing for atherosclerosis and related conditions.
- To understand the diagnostic workup for patients presenting with established vascular disease or risk factors.
Summary:
- Identified 372 patients with vascular disease and 317 with risk factors.
- Diagnostic tests for carotid stenosis, peripheral artery disease, and abdominal aortic aneurysm were performed in less than 6% of relevant patients.
- Screening for diabetes mellitus and hyperlipidemia varied significantly depending on the presenting condition, indicating inconsistent practice.
Impact:
- Suggests suboptimal screening protocols for asymptomatic macrovascular disease in routine clinical practice.
- Highlights potential for improved patient outcomes through more comprehensive and consistent screening.
- Provides data to inform guidelines and quality improvement initiatives for vascular disease management.
Objective:
To assess current practice in screening for asymptomatic vascular disease and risk factors in patients referred with vascular disease or cardiovascular risk factors.
Design:
Descriptive, retrospective.
Setting:
University Hospital Utrecht, Utrecht, the Netherlands.
Method:
By means of the computerized hospital registration system all patients who were referred to the outpatient clinic with carotid stenosis, peripheral artery disease, abdominal aortic aneurysm, diabetes mellitus, hyperlipidaemia or hypertension during one year were identified. By means of the same hospital registration system the frequency of diagnostic tests performed to detect atherosclerosis or risk factors in these patients within a period of 5 months round the first attendance was determined.
Results:
372 Patients with a vascular disease and 317 patients with a risk factor were identified. Tests to detect carotid stenosis, peripheral artery disease or an abdominal aortic aneurysm were each performed in less then 6% of all patients except the test for abdominal aortic aneurysm. Tests to detect coronary artery disease were performed in about 50% of all patients. Tests to detect diabetes mellitus were performed in 35% of the patients with vascular disease and in 81% of the patients presenting with hyperlipidaemia or hypertension. Tests to detect hyperlipidaemia were performed in 18% of the patients with a vascular disease and in 76% of the patients with diabetes or hypertension.
Conclusion:
The results of this study suggest that in current practice patients referred for vascular disease or cardiovascular risk factors are infrequently screened for asymptomatic macrovascular disease and risk factors.