Is Early Detection Enough to Prevent Cardiovascular Deaths?

In line with recommendations from the US Preventive Services Task Force, millions of adults are screened each year for hypertension, diabetes, and high cholesterol in a bid to detect these conditions early and save lives. However, a recent study suggests that routine screenings for these conditions may not have a significant impact on cardiovascular or all-cause mortality.

In a cohort study published in The Journal of Clinical Hypertension, Researchers shared their findings after studying a nationally representative sample of 86,597 US adults for 4.3 years. At baseline, none of the participants had hypertension, diabetes, high cholesterol, or cardiovascular disease. A history of screening was obtained using surveys. Researchers determined all-cause and cardiovascular mortality by linking participant data to the National Death Index records. Using multivariable Cox regression analysis, researchers investigated the association between screenings and mortality, expressed as a hazard ratio (HR) with a 95% confidence interval (CI). They also adjusted for major risk factors of cardiovascular disease and death, such as having cancer or kidney failure. Participants with one screening, two screenings, three screenings, and any screenings (combining all three groups) were compared with the no screening group.

After 4.3 years, 1,783 participants died, and 366 of those deaths were from cardiovascular disease. When adjustments were made for all covariates, no statistically significant link was found between any screening and all-cause mortality (HR, 1.08; 95% CI, 0.92–1.26). No statistically significant link was found for cardiovascular mortality either (HR, 1.06; 95% CI, 0.76–1.47). These results were consistent across all subgroups of age, sex, race, lifestyle factors, and comorbidities.

The study suggests that screenings may not independently lower mortality rates, though they are useful for early detection and management. The researchers acknowledge that the study’s short follow-up period of 4.3 years may have limited its statistical power. They also caution that “the study’s statistically insignificant results should not deny the potential value of screening in the primary prevention of cardiovascular disease.”