What are the screening recommendations for the noncoronary atherosclerosis?

Answer

Cardiovascular disease (CVD) risk factors associated with lifestyle include smoking, alcohol intake, diet, and exercise. Screening guidelines for modifiable lifestyle CVD risks in adults have been issued by the following organizations:

US Preventive Services Task Force (USPSTF)
American Heart Association (AHA)/American College of Cardiology (ACC)
European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS)

A comparison of the recommendations for diet, physical activity, and tobacco use screening and interventions are listed in Table 1, below.

Table. Screening and Intervention Recommendations for Diet, Physical Activity, and Tobacco Use (Open Table in a new window)

Adult Guidelines	Year	Risk Factor	Screening Populations	Recommended Interventions
US Preventive Services Task Force (USPSTF)^[12]	2014	Diet and physical activity	Overweight or obese adults with additional cardiovascular risk	Intensive behavioral counseling interventions to promote a healthful diet and physical activity
USPSTF^[13]	2012	Diet and physical activity	Adult without obesity who do not have known CVD risk factors	Primary care professionals should individualize the decision to offer or refer adults without obesity who do not have hypertension, dyslipidemia, abnormal blood glucose levels, or diabetes to behavioral counseling to promote a healthful diet and physical activity.
American Heart Association^[14]	2010	Diet and physical activity	All adults	Clinicians should provide individual or group-based interventions to promote and maintain healthy diet and physical activity that include a combination of two or more of the following strategies: Setting specific, proximal goals Providing feedback on progress Providing strategies for self-monitoring Establishing a plan for frequency and duration of follow-up Using motivational interviews Building self-efficacy
European Society of Cardiology/European Atherosclerosis Society (ESC/EAS)^[15]	2012	Diet, physical activity, and tobacco use	All adults	Risk estimation for CVD using the Systematic COronary Risk Evaluation (SCORE) All smokers offered assistance to quit All patients encouraged to adopt healthy diet and increase physical activity Multimodal behavioral interventions, integrating health education, physical exercise, and psychological therapy for psychosocial risk factors and coping with illness, should be prescribed for all patients with CVD
USPSTF^[16]	2015	Tobacco Use	All adults	Ask all adults, including pregnant women, about tobacco use; advise those who use tobacco to stop using it, and provide behavioral interventions and US Food and Drug Administration-approved pharmacotherapy for smoking cessation.

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Table. Screening and Intervention Recommendations for Diet, Physical Activity, and Tobacco Use

Table. Screening and Intervention Recommendations for Diet, Physical Activity, and Tobacco Use

Adult Guidelines	Year	Risk Factor	Screening Populations	Recommended Interventions
US Preventive Services Task Force (USPSTF)^[12]	2014	Diet and physical activity	Overweight or obese adults with additional cardiovascular risk	Intensive behavioral counseling interventions to promote a healthful diet and physical activity
USPSTF^[13]	2012	Diet and physical activity	Adult without obesity who do not have known CVD risk factors	Primary care professionals should individualize the decision to offer or refer adults without obesity who do not have hypertension, dyslipidemia, abnormal blood glucose levels, or diabetes to behavioral counseling to promote a healthful diet and physical activity.
American Heart Association^[14]	2010	Diet and physical activity	All adults	Clinicians should provide individual or group-based interventions to promote and maintain healthy diet and physical activity that include a combination of two or more of the following strategies: Setting specific, proximal goals Providing feedback on progress Providing strategies for self-monitoring Establishing a plan for frequency and duration of follow-up Using motivational interviews Building self-efficacy
European Society of Cardiology/European Atherosclerosis Society (ESC/EAS)^[15]	2012	Diet, physical activity, and tobacco use	All adults	Risk estimation for CVD using the Systematic COronary Risk Evaluation (SCORE) All smokers offered assistance to quit All patients encouraged to adopt healthy diet and increase physical activity Multimodal behavioral interventions, integrating health education, physical exercise, and psychological therapy for psychosocial risk factors and coping with illness, should be prescribed for all patients with CVD
USPSTF^[16]	2015	Tobacco Use	All adults	Ask all adults, including pregnant women, about tobacco use; advise those who use tobacco to stop using it, and provide behavioral interventions and US Food and Drug Administration-approved pharmacotherapy for smoking cessation.

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Author

F Brian Boudi, MD, FACP Clinical Associate Professor, University of Arizona College of Medicine (Phoenix Campus); Fellow, Sarver Heart Center, University of Arizona College of Medicine; Regional Faculty, American Heart Association; Adjunct Assistant Professor of Medicine, Mid-Western University; Staff Physician, Site Director for Clinical Rotations Emergency Medicine, Phoenix Veterans Administration Health Care System

F Brian Boudi, MD, FACP is a member of the following medical societies: American Association for the Advancement of Science, American College of Cardiology, American College of Physicians, American Society of Echocardiography, Arizona Medical Association, Association of Program Directors in Internal Medicine, American College of Healthcare Executives, American Society of Nuclear Cardiology

Disclosure: Nothing to disclose.

Coauthor(s)

Chowdhury H Ahsan, MD, PhD, MRCP, FSCAI Clinical Professor of Medicine, Director of Cardiac Catheterization and Intervention, Marlon Cardiac Catheterization Laboratory, Director of Cardiovascular Research, University Medical Center, University of Nevada School of Medicine

Chowdhury H Ahsan, MD, PhD, MRCP, FSCAI is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, Society for Cardiovascular Angiography and Interventions, American Stroke Association

Disclosure: Received consulting fee from sanofi for consulting; Received honoraria from astra zeneca for speaking and teaching; Received honoraria from BI for speaking and teaching.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Steven J Compton, MD, FACC, FACP, FHRS Director of Cardiac Electrophysiology, Alaska Heart Institute, Providence and Alaska Regional Hospitals

Steven J Compton, MD, FACC, FACP, FHRS is a member of the following medical societies: American College of Physicians, American Heart Association, American Medical Association, Heart Rhythm Society, Alaska State Medical Association, American College of Cardiology

Disclosure: Nothing to disclose.

Chief Editor

Yasmine S Ali, MD, FACC, FACP, MSCI President, LastSky Writing, LLC; Assistant Clinical Professor of Medicine, Vanderbilt University School of Medicine

Yasmine S Ali, MD, FACC, FACP, MSCI is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, National Lipid Association, Tennessee Medical Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: MCG Health, LLC; LastSky Writing, LLC; Philips Healthcare; Cardiac Profiles, Inc.; BBN Cardio Therapeutics.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors James L Orford, MBChB and Andrew P Selwyn, MD, MA, FACC, FRCP, to the development and writing of the source article.

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