May 9, 2011

Age Used to Screen Stroke?

(Ivanhoe Newswire) -- Age alone could ultimately replace contemporary screening methods with no diminishing efficacy to identify those at risk of heart disease or stroke.

Current screening methods, which include measuring cholesterol and blood pressure, are costly as well as time consuming.  The authors of the new-fangled study from Barts and The London Medical School say that this discovery could save thousands of lives by making it easier for more people to have access to preventive treatment.

The study compared screening via age on its own with screening using age as well as multiple risk factors, measured by means of blood tests and medical examination.  The authors used existing data to approximate the effects of the two screening approaches on a modeled population of 500,000 people.

Age screening alone using a cut off of 55 years had an 84 percent detection rate and a 24 percent false-positive rate.  This is comparable to properly identifying 84 percent of all the people in a population who will have a stroke or heart attack, while incorrectly identifying 24 percent who will not.  Modern screening methods can achieve the same 84 percent detection rate with a false-positive rate that is only slightly less "“ 21 percent.

"This study shows that age screening for future cardiovascular disease is simpler than current assessments, with a similar screening performance and cost effectiveness.  It also avoids the need for blood tests and medical examinations," which Professor Sir Nicholas Wald, lead author and Director of the Wolfson Institute at Barts and The London School of Medicine and Dentistry, part of Queen Mary, University of London, was quoted as saying.

With age screening, all individuals above a particular age would be offered preventive treatment.  Everyone would benefit because, for blood pressure and cholesterol, the lower the better.  The policy of choosing people above a certain age is, in effect, selecting people at high risk.  It recognizes that age is by far the most important determinant of that risk with other factors adding little extra prognostic information.

"Prevention is better than measurement," Professor Wald added.  "Identifying people at high risk of cardiovascular disease needs to be greatly simplified, enabling people to obtain easy access to preventive treatment from nurses and pharmacists as well as from doctors."

He also said offering appropriate preventive treatment to everyone aged 55 and over in England and Wales could prevent over 100,000 heart attacks and strokes every year.

SOURCE: PLoS ONE, May 5, 2011