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Carotid ultrasound to prevent stroke

Q. I often receive offers in the mail to perform an ultrasound of my carotid arteries. Should I sign up for a carotid ultrasound?

A. You probably don’t need this test unless you are experiencing certain warning signs. Stroke is the third leading cause of death in the United States, and the major risk factors for stroke are age, high blood pressure, and cigarette smoking. Narrowing of the carotid arteries could cause a clot that blocks blood flow to the brain (ischemic stroke).

In people who have had a stroke or warning symptoms known as transient ischemic attacks or TIAs, opening a severely blocked carotid artery reduces the risk of future stroke. But because carotid surgery itself carries the risk of causing a stroke, it’s important to perform the procedure only on people who really need it. It’s not well established that the benefits of opening a blocked artery in people with no symptoms outweigh the risks. In addition, screening people at low risk only identifies 1% or 2% who have severely narrowed carotid arteries. That means you are unlikely to benefit from the screening.

Given that the potential risks of treatment may outweigh any benefits, most medical societies do not suggest routine carotid ultrasound testing. It may provide false reassurance or lead to unnecessary procedures. A better prevention plan is to focus on reducing your risk factors: stop smoking, keep your blood pressure under control, monitor your cholesterol, and eat a healthy diet low in sodium and red meat.

— William Kormos, M.D.
Editor in Chief, Harvard Men’s Health Watch

Posted by: Dr.Health

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