Health & Wellness for a LIFETIME
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Archive:
- 2012
- January (11)
- PFC Lowers Antibodies!
- People Don't Stop Smoking After Seing Plaque in Carotids!
- Pharmaceutical Companies and Physicians
- Importance of Vitamin D
- Statin Drugs and Diabetes
- Heart Attacks and Long Distance Running
- Wasted Research Money?
- Nicotine Patch Ineffective
- So How Much Exercise Can You Squeeze In?
- Neti-Pot Problems
- AHA Study: Heart Disease Increasing
- 2011
- December (11)
- Cranberries vs. Antibiotics for UTI
- Antioxidants Reduce Cancer Risk
- Back Surgery: Too Many, Too Costly, Too Ineffective!
- Simvastin (Zocor, Vytorin, Simcor) Danger
- Physicians Rate Insurance Companies
- Anti-coagulant Drug Problems
- Bad News about Stop Smoking Drug
- Antibiotics: Inappropriately Used
- Exercise More Important Than BMI
- Pediatric Antibiotis: Over Prescribed?
- FDA Criticized Dr. Oz But Was It Fair?
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Can Carotid Ultrasound Screening Motivate Smokers to Quit?
In a randomized trial, screening was ineffective.
One possible role of cardiovascular (CV) screening tests is to motivate people with abnormal results to make lifestyle changes. To see whether this strategy works, Swiss researchers randomized 536 heavy smokers (age range, 40–70) to receive carotid ultrasound screening or no screening. Those with carotid plaques (58% of screened patients) received photographs of the plaques along with detailed explanations. Patients in both groups received intensive smoking cessation counseling.
Smoking abstinence rates at 1 year (confirmed by measurement of exhaled carbon monoxide and serum cotinine levels) were about 20% in both groups. Moreover, 12-month changes in CV risk factors such as lipid levels and blood pressure were similar in the two groups. Within the screening group, smoking cessation outcomes in patients with plaques did not differ significantly from outcomes in those without plaques.
Comment: Carotid ultrasound screening failed to motivate patients to quit smoking, over and above smoking cessation counseling. These findings — added to the evidence that patients with asymptomatic carotid stenosis who receive contemporary preventive medical therapies are unlikely to benefit from carotid revascularization (JW Gen Med Sep 15 2011) — suggest that carotid screening is not appropriate. An editorialist argues that, to motivate patients, improving patient–physician communication and relationships is a more-promising approach than ordering tests.
In essence, if the carotid ultrasound shows that a patient is at a high reisk for a stroke and the patient refuses to make necessary lifestyle changes, then what is the point of doing the test to begin with? If there is a 90% obstruction and the patient undergoes surgery, but does not change his/her eating habits, the patient will not benefit from the surgery because there will be a fast recurrence.
To be honest, the results of this study is not at all surprising considering that the average person who suffers a heart attack is scared and improves his/her lifestyle for a couple of months then slips back to old habits...until the second heart attack. If a heart attack and almost death does not scare the patient, then certainly a picture of plaque partially blocking an artery is not going to encourage the patient to take better care of him/herself.....unfortunately.