Cardiovascular Disease Prevention Notes

Prevention of Cardiovascular Disease: Expert Recommendations (USPSTF)

Screening for Abdominal Aortic Aneurysm (AAA)

  • Men aged 65-75 who have ever smoked:

    • Recommendation: One-time screening for AAA via ultrasonography. (B) [2019]

  • Men aged 65-75 who have never smoked:

    • Recommendation: Selectively offer screening for AAA. (C) [2019]

  • Women aged 65-75 who have ever smoked or have a family history of AAA:

    • Recommendation: Current evidence is insufficient to assess the balance of benefits and harms of screening. (I) [2019]

  • Women who have never smoked and have no family history of AAA:

    • Recommendation: Against routine screening for AAA. (D) [2019]

Aspirin Use for Primary Prevention of CVD

  • Adults aged 40-59 with a 10% or greater 10-year CVD risk:

    • Recommendation: The decision to initiate low-dose aspirin should be an individual one. The net benefit is small.

    • Considerations: Benefit is more likely for those not at increased risk for bleeding and willing to take low-dose aspirin daily. (C) [2022]

  • Adults aged 60 or older:

    • Recommendation: Against initiating low-dose aspirin for primary prevention of CVD. (D) [2022]

Blood Pressure Screening

  • Adults aged 18 or older:

    • Recommendation: Screen for hypertension with office blood pressure measurement.

    • Diagnostic Confirmation: Confirm with blood pressure measurements outside of the clinical setting before starting treatment. (A) [2021]

Serum Lipid Screening and Statin Use for Prevention

  • Adults aged 40-75 with one or more CVD risk factors (dyslipidemia, diabetes, hypertension, or smoking) and an estimated 10-year risk of a cardiovascular event of 10% or greater:

    • Recommendation: Prescribe a statin for primary prevention of CVD. (B) [2022]

  • Adults aged 40-75 with one or more CVD risk factors and an estimated 10-year risk of a cardiovascular event of 7.5% to less than 10%:

    • Recommendation: Selectively offer a statin for primary prevention of CVD. The likelihood of benefit is smaller than for those with a 10% or greater risk. (C) [2022]

  • Adults aged 76 or older:

    • Recommendation: Current evidence is insufficient to assess the balance of benefits and harms of initiating a statin for primary prevention of CVD events and mortality. (I) [2022]

Counseling About Healthful Diet and Physical Activity

  • Adults with CVD risk factors:

    • Recommendation: Offer or refer to behavioral counseling interventions to promote a healthy diet and physical activity. (B) [2020]

  • Adults without CVD risk factors:

    • Recommendation: Individualize the decision to offer or refer to behavioral counseling interventions to promote a healthy diet and physical activity. (C) [2022]

Screening for Diabetes Mellitus

  • Adults aged 35-70 who have overweight or obesity:

    • Recommendation: Screen for prediabetes and type 2 diabetes.

    • Prediabetes Management: Offer or refer patients with prediabetes to effective preventive interventions. (B) [2021]

Screening for Smoking and Counseling for Cessation

  • All adults:

    • Recommendation: Ask about tobacco use, advise them to stop, provide behavioral interventions, and prescribe FDA-approved pharmacotherapy to nonpregnant adults. (A) [2021]

USPSTF Recommendation Definitions

  • Recommendation A: The USPSTF strongly recommends the service; good evidence shows it improves health outcomes, and benefits substantially outweigh harms.

  • Recommendation B: The USPSTF recommends the service; at least fair evidence shows it improves health outcomes, and benefits substantially outweigh harms.

  • Recommendation C: The USPSTF makes no recommendation for or against the service.

  • Recommendation D: The USPSTF recommends against the service; at least fair evidence shows it is ineffective or harms outweigh benefits.

  • Recommendation I: The USPSTF concludes that evidence is insufficient to recommend for or against the service.