What is Carotid Intima-Media Thickness & Why is it Important?
Cardiovascular disease, the #1 killer in the US, affects one out of three adults and leads to conditions such as stroke, heart attack, abdominal aortic aneurysm (AAA) and various lower extremity conditions ranging from pain in the legs associated with walking to amputation. The patient often times does not have symptoms or warning signs before a devastating event occurs, such as heart attack or stroke.
Carotid Intima-Media Thickness (CIMT) screening allows for early intervention and prevention of disease by identifying more of these patients without symptoms so they can be treated by their physician before they experience such an event.
Carotid Intima-Media Thickness (CIMT) study is a noninvasive ultrasound screening exam of the carotid arteries (the large artery on each side of the neck) which measures the thickness of the inner layer of the carotid arteries. Ultrasound and special software measure the thickness of the intima (innermost layer) and media (the middle layer) of the common carotid artery. Based on the thickness of the intima and media, individuals are classified as being at a low or increased cardiovascular atherosclerotic related risk, such as stroke and heart attack.
Who Should Have a CIMT Screening?
- Apparently healthy individuals ages 45 or greater.
- Individuals with an intermediate Framingham Risk Score
- Family history of premature (men <55 years old, women <65 years old) heart attack or stroke in a first-degree relative.
- Individuals <60 years old with a single cardiovascular risk factor who otherwise would not be candidates for pharmacotherapy.
- Women younger than 60 years old with at least 2 CVD risk factors
What Information Does the CIMT Screening Test Provide?
Adding CIMT to traditional risk prediction scores improves cardiovascular risk prediction. Based on the thickness of the intima and media, individuals are classified as being at a low or increased cardiovascular atherosclerotic related risk.
In other words, CIMT is an independent predictor of future cardiovascular events, including heart attacks, cardiac death, and stroke. The condition of the carotid arteries provides an indication of the condition of other arteries in the heart and brain and thus allows for earlier detection of atherosclerotic disease and prevention of heart attack or stroke.
Each screening exam will only take about 20-30 minutes. A final report will be mailed to the participant and his/her primary care physician within 5 working days. With this information, physicians may develop an aggressive medical approach by prescribing medications such a blood pressure and cholesterol lowering agents and aspirin, and patients may be encouraged make lifestyle and dietary improvements.
Who Supports Carotid Intima-Media Screenings?
CIMT screening exam is recommended by the American Heart Association and the American College of Cardiology to screen for heart disease in apparently healthy individuals ages 45 or greater with intermediate traditional risk prediction scores.
Are You at Risk for Cardiovascular Disease?
- Tobacco use/Smoking
- Unhealthy blood cholesterol levels
- Hypertension (high blood pressure)
- Physical inactivity
- Obesity and overweight
- Poor diet
- Diabetes
Will Insurance Companies Pay for Screening Exams? How Much Does it Cost?
Most insurance companies will not pay for screening exams in the absence of signs or symptoms of vascular disease. Pacific Vascular does not file insurance claims for screening exams. Because you are being seen without established medical necessity, insurance payors will not cover the cost of the screening procedure. Thus, you, the recipient of the screening, are responsible for the cost prior to the exam. The cost of the CIMT screening is $140 and is due at time of service.
By choosing to reduce your risk factors, you may prevent heart attack, stroke, or peripheral arterial disease and its debilitating complications.
Know your blood pressure
- High blood pressure usually has no signs or symptoms.
- See your doctor to get your blood pressure checked, at least once each year.
- Work with your doctor to keep your blood pressure under control.
If you smoke, stop!
Know your blood cholesterol level
- Abnormal cholesterol levels usually have no signs or symptoms.
- If abnormal, control by medication, diet and/or exercise.
Control your diabetes
Work with your doctor to keep your diabetes under control, through nutrition, lifestyle changes, and medicine.
Eat a healthy diet
- A diet containing five or more servings of fruits and vegetables per day may reduce the risk of stroke.
- Eat foods that are low in total fat, saturated fat, trans fat, cholesterol, and sodium (salt).
- Diets high in saturated fat, trans fat and cholesterol can raise blood cholesterol levels.
- Diets high in sodium (salt) can contribute to increased blood pressure.
- Diets with excess calories can contribute to obesity.
Exercise every day
- Try to get a total of at least 30 minutes of activity on most or all days.
- Talk to your doctor about what types of activity are safe for you.
See your doctor regularly
References:
American Heart Association www.americanheart.org
National Stroke Association www.stroke.org
National Heart, Lung, and Blood Institute www.nhlbi.nih.gov
