For some time, I have been using carotid ultrasound and cardiac echocardiography to help assess my patient's cardiovascular risk. I believe that documenting atherosclerosis in the carotid (need for intensive lipid control, diet and exercise) and evidence of hypertension on echo - increased left atrial size or diastolic dysfunction (need for BP control, diet, exercise) is very helpful to reduce my patients future risk of cardiovascular events.
Now it appears that there is definitive evidence that this is the right approach, specifically in women.
MedPage Today (6/16, Phend) reported that "ultrasound imaging of the heart and the main artery to the brain may paint a dramatically different picture of cardiovascular health in women thought to be at low risk by traditional factors," according to a study presented at the American Society of Echocardiography meeting. Investigators found that, "despite being judged at low cardiovascular event risk by the widely-used Framingham risk score, ultrasound imaging of a small cohort of women (most obese or with metabolic syndrome) revealed abnormalities in the carotid artery, in left ventricular or left atrial size, or in diastolic function." The investigators "recommended screening women diagnosed with obesity or metabolic syndrome using selected ultrasound imaging to help further risk-stratify such patients."