Harvard Heart Letter

"Just in case" artery scans offer little or no payoff, possible harm

The carotid arteries that run up either side of the neck are prone to becoming narrowed by cholesterol-filled plaque. A test called carotid ultrasound can identify a narrowing, also called a stenosis, quickly, safely, and without any immediate potential for harm. This test makes perfect sense for someone experiencing lightheadedness, memory loss, or the warning signs of a stroke or mini-stroke.

In people who have their carotid arteries checked "just in case," ultrasound doesn't do much good. University of Wisconsin researchers tracked almost 600 people who underwent carotid ultrasound for this reason. A year later, those whose scans had shown a significant narrowing were no more likely to have their blood pressure or cholesterol under control — two key steps for managing carotid stenosis — than those whose arteries were clear, or to have made healthy changes in diet, exercise, and other long-term health behaviors (Archives of Internal Medicine, March 28, 2011).

Tests like these in seemingly healthy individuals often cause more problems than they prevent. They can quickly transform people into worried folks who need more tests, and maybe even procedures. And these procedures can't make them feel better, because they started out feeling fine.

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