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The DanCavas Pilot Study of Multifaceted Screening for Subclinical Cardiovascular Disease in Men and Women Aged 65–74 Years

  • T. V. Kvist*
  • , J. S. Lindholt
  • , L. M. Rasmussen
  • , R. Søgaard
  • , J. Lambrechtsen
  • , F. H. Steffensen
  • , L. Frost
  • , M. H. Olsen
  • , H. Mickley
  • , J. Hallas
  • , G. Urbonaviciene
  • , M. Busk
  • , K. Egstrup
  • , A. C.P. Diederichsen
  • *Corresponding author for this work

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objective/Background This pilot study of a large population based randomised screening trial investigated feasibility, acceptability, and relevance (prevalence of clinical and subclinical cardiovascular disease [CVD] and proportion receiving insufficient prevention) of a multifaceted screening for CVD. Methods In total, 2060 randomly selected Danish men and women aged 65–74 years were offered (i) low dose non-contrast computed tomography to detect coronary artery calcification (CAC) and aortic/iliac aneurysms; (ii) detection of atrial fibrillation (AF); (iii) brachial and ankle blood pressure measurements; and (iv) blood levels of cholesterol and hemoglobin A1c. Web based self booking and data management was used to reduce the administrative burden. Results Attendance rates were 64.9% (n = 678) and 63.0% (n = 640) for men and women, respectively. In total, 39.7% received a recommendation for medical preventive actions. Prevalence of aneurysms was 12.4% (95% confidence interval [CI] 9.9–14.9) in men and 1.1% (95% CI 0.3–1.9) in women, respectively (p < .001). A CAC score > 400 was found in 37.8% of men and 11.3% of women (p < .001), along with a significant increase in median CAC score with age (p = .03). Peripheral arterial disease was more prevalent in men (18.8%, 95% CI 15.8–21.8) than in women (11.2%, 95% CI 8.7–13.6). No significant differences between the sexes were found with regard to newly discovered AF (men 1.3%, women 0.5%), potential hypertension (men 9.7%, women 11.5%), hypercholesterolemia (men 0.9%, women 1.1%) or diabetes mellitus (men 2.1%, women 1.3%). Conclusion Owing to the higher prevalence of severe conditions, such as aneurysms and CAC ≥ 400, screening for CVD seemed more prudent in men than women. The attendance rates were acceptable compared with other screening programs and the logistical structure of the screening program proved successful.

    Original languageEnglish
    Pages (from-to)123-131
    Number of pages9
    JournalEuropean Journal of Vascular and Endovascular Surgery
    Volume53
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2017

    Funding

    This work was supported by Region Syddanmark, Elitary Research Centre of Individualised Medicine in Arterial Disease (CIMA), Hjerteforeningen, Odense University Hospital and Helseforeningen.

    Keywords

    • Aortic aneurysm
    • Cardiovascular prevention
    • Computed tomography
    • Coronary calcium score
    • Peripheral arterial disease
    • Screening

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