Community-Based Screening:

Identifying Risk and Motivating Healthy Lifestyle Changes

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Steven M. Weisman, PhD; Andrew J. Manganaro, MD

Table of Contents

Postgraduate Medicine:

Volume 125 No. 4

Category:

Clinical Features

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DOI: 10.3810/pgm.2013.07.2675
Abstract: Background: Smoking cessation, exercise, healthy diet, blood pressure control, and lipid management can substantially decrease patients’ risk for cardiovascular disease. Methods: Data collected from cardiovascular screenings conducted by Life Line Screening, LLC, from a representative sample period (2005–2008) (n = 2 714 230), along with results of a 2012 follow-up survey (n = 1967), were evaluated. Participants were self-referred and screened across the United States for peripheral artery disease, abdominal aortic aneurysm, atrial fibrillation, and carotid artery stenosis. Participants also reported medical history and health-related lifestyle factors. Screening data were standardized to the US population aged ≥ 50 years by year, sex, age, and race. Risk factors, manifestations of cardiovascular disease, and Reynolds Risk Scores were examined. The representativeness of the unique Life Line Screening Database data set was compared with that of the Behavioral Risk Factor Surveillance System (n = 827 078) and the National Health Interview Survey (n = 42 755), both of which have been shown to be nationally representative. Results: Strong associations were found between dissimilar manifestations of cardiovascular disease. The data set was found to be broadly representative of Americans aged ≥ 50 years after standardization and provides insight on risk factors and disease progression. Survey results demonstrate the value of screening in enhancing physician engagement, and in motivating patients to maintain a healthier diet, engage in more exercise, stop smoking, and manage their medication, hereafter referred to as improved health behavior. Conclusion: Older Americans who seek community-based screening present with a variety of modifiable risk factors and asymptomatic vascular conditions, which are linked to adverse cardiovascular outcomes, including stroke and myocardial infarction. The follow-up survey indicated that community-based screening may be a motivating factor toward improved health behavior and use of medical resources.

Keywords: cardiovascular; community-based screening; Life Line Screening; risk factors; database