New Heart Screening Test Recommended for Most Older Women


From the WebMD Archives

Sept. 9, 1999 (Cleveland) — Researchers now say that most women aged 60 and over should be tested with a new imaging device called electron beam CT, or ultrafast CAT scan, to detect the earliest signs of heart disease.

Lewis Kuller, MD, DrPH, tells WebMD that his work with the Healthy Women Study has convinced him that most women will benefit from this new screening test. “And the best part is that it is so safe. It doesn’t hurt, and it’s fast,” he says. Usually cardiologists rely upon angiograms, a test in which dye is injected into the arteries. Although the procedure is very common, it carries a risk because it is invasive. Kuller is professor and chairman of the department of epidemiology at the University of Pittsburgh’s Graduate School of Public Health. His study is published in the September issue of Arteriosclerosis, Thrombosis and Vascular Biology.

The ultrafast CAT scan is a type of computerized X-ray that is especially effective at detecting tiny amounts of calcium in the arteries. Calcium deposits are considered a precursor to atherosclerosis, a build-up of plaque in the arteries that can eventually lead to a heart attack. The scan is graded for the presence of calcium, with a “0” indicating no calcium; scores into the 1000s represent extensive amounts of plaque.

Kuller says that the ability to identify heart disease before any symptoms develop is very exciting because there are ways to stop it from progressing. “We can urge lifestyle changes such as dieting, switching to a low-fat diet, exercise, no smoking, and moderate alcohol use,” he says. There are also effective drug treatments to lower cholesterol or control blood pressure.

“We have known for some time that as women age, the risk of coronary artery disease and stroke increases. Some people say that women catch up to men, who have a lifetime higher risk. This is true for stroke but this isn’t true for heart disease. Actually, at age 60, only about 30% of women are at risk for a coronary event or heart attack,” he says. Kuller says that by using ultrafast CAT scan to identify that 30%, doctors will know how to accurately direct treatment and prevention.

Kuller and his fellow researchers found that in premenopausal women an LDL, or bad cholesterol, of more than 130 was associated with calcium in the arteries, whereas an HDL, or good cholesterol, of more than 60 essentially prevented any calcium build-up.

Unfortunately, ultrafast CAT scan is not widely available. Currently, only about 50 centers nationwide offer the test. “And many insurers won’t pay for it,” says Kuller. But he predicts that the technology will catch on. Moreover, some manufacturers are testing ways to convert traditional scanning equipment, which is available at most hospitals. “When that happens, [the new technology] will be everywhere,” says Kuller. In the meantime, consumers can expect to pay about $350 for the test.

This research was supported by a grant from the National Institutes of Health.

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