Risks outweigh benefits in Broward’s heart test plan

I oppose the proposed Broward County sales tax increase to pay for routine cardiac CT angiograms among qualifying residents.

This proposal (which requires voter approval) lacks evidence-based medical support. According to American College of Cardiology guidelines, there is insufficient evidence to warrant cardiac CT angiograms for routine screening purposes in asymptomatic people.

The risks outweigh potential benefits. They include radiation exposure; unnecessary subsequent tests; unnecessary procedures (cardiac catheterization, coronary stenting, surgery); unnecessary patient worry; and excessive medical costs. Emphasis should be on proven preventative strategies: diet, exercise, smoking cessation, weight management, blood pressure, cholesterol and diabetes screening.

Currently, cardiac CT angiograms are indicated tests for select patients with chest pain or a known cardiac condition that warrants the test. Another indicated less-invasive CT called a coronary artery calcium (CAC) test may be appropriate for select at-risk patients. Both should only be conducted after consultation and coordination with trained medical professionals.

We certainly need ethically conducted clinical trials to determine whether widespread use of cardiac CT angiograms saves lives. There is no scientific basis for this approach. Research could prove that this approach makes sense. As a cardiologist, I certainly hope that the science continues to evolve to aid in better early cardiac disease detection and prevention. Cardiovascular disease remains one of the leading causes of morbidity and mortality in the U.S.

Although we applaud the Broward County leadership for taking on public health initiatives to reduce the burden of cardiovascular disease, there are more cost-effective ways to achieve this goal. Individuals should consult with their doctors regarding appropriate vs. inappropriate health screening tests.

Joshua M. Larned, M.D., Fellow, American College of Cardiology (FACC), Fort Lauderdale