Call It Tragic That All Americans Can’t Benefit From Such Life-Saving Screening Tests Due to Lack of Insurance and Medicare Coverage

HOUSTON, December 17, 2004 – The Association for Eradication of Heart Attack (AEHA) today congratulated President Bush for undergoing preventive screening to evaluate his risk of unheralded heart attack. President Bush underwent a comprehensive atherosclerosis screening test as part of his annual physical exam. Leading cardiologists and cardiovascular researchers from around the world who joined the organization’s SHAPE Task Force (Screening for Heart Attack Prevention and Education) say the outcomes are evidence of the value of such preventive screening measure, even among men and women who are physically fit and appear healthy.

According to news reports, doctors found evidence of a small amount of calcification (indicating plaque build-up) in the President’s coronary arteries through noninvasive CT imaging of his heart. As a result of this finding, they recommended that President Bush take a daily aspirin and a cholesterol-lowering drug.

“We are pleased to see that the President’s medical team is leading the way for the rest of the medical community by adopting screening for subclinical disease,” said Dr. Jay Cohn, a member of the AEHA SHAPE Task Force and professor of medicine, at the University of Minnesota Medical School, and director of the Rasmussen Center for Cardiovascular Disease Prevention. “We hope that a comprehensive vascular structural and functional assessment will be included in every American’s preventive care.”

“The fact that a coronary calcium imaging found that the President – a man in good physical condition – can benefit from a cholesterol lowering medication illustrates the potential value of such non-invasive screening tests,” said Dr. Morteza Naghavi, founder and president of AEHA.

AEHA and its SHAPE Task Force are made up of leading cardiologists and researchers from around the world. They believe that the medical community’s reliance solely upon traditional risk factors to identify patients in need of intervention has a number of limitations. The group is advocating the National SHAPE Program, a new approach based on screening for subclinical disease, in addition to traditional risk factor based assessment, to help physicians identify “the vulnerable patient,” individuals at very high risk of a heart attack in the near future.

Modeled after successful screening efforts in the cancer care arena, the SHAPE initiative encourages men 45 and older and women 55 and older to undergo screening to determine the risk of heart attack. Today, two methods are widely available to doctors that are effective ways to assess presence and severity of structural abnormalities namely plaque buildup or thickening in the arteries (atherosclerosis):

  • Coronary calcium score using a CAT scan , which is used to determine the burden of plaque build-up in the coronary arteries; and
  • Thickness of the carotid artery wall and presence of plaque measured by ultrasound, which correlates with an individual's total burden of arterial plaque build-up or atherosclerosis.

In addition to imaging the aorta and carotid arteries by MRI to assess total body plaque burden, vigorous clinical validation is underway into promising new developments that might make possible even earlier detection of at-risk individuals by non-invasive non-imaging tests such as arterial compliance (elasticity) and vascular reactivity (endothelial function). These tests are aimed at measuring the functional abnormalities of the vascular system and may complement the structural assessment of plaque burden. 

“The tragedy is that most insurance programs and Medicare fail to cover these procedures, so they remain out of financial reach of the average American,” said Dr. Harvey Hecht, a member of the AEHA SHAPE Task Force and director of preventive cardiology at Beth Israel Medical Center in New York. “It defies reason that cancer screening procedures, such as colonoscopy and mammography are well accepted and reimbursed by the government and insurance companies while life-saving screening tests for prevention of heart attack, the number one killer in this country, are not covered.”

“It is time for the medical establishment and the government to insist that these tests be made available to all Americans who may benefit from them, irrespective of their ability to pay,” said Dr. Daniel Berman, another member of the SHAPE Task Force and director of cardiac imaging and nuclear cardiology at Cedars-Sinai Medical Center in Los Angeles. “An increasing number of powerful therapies are being introduced that can effectively prevent heart attacks. A multi-step screening, as outlined in SHAPE, can provide the key to identifying those who need the treatment and can benefit the most, before the event occurs.”

The SHAPE Task Force called it encouraging that the Centers for Medicare & Medicaid Services has established coverage for cardiovascular screening for the first time. However, the coverage is limited to a blood test to determine cholesterol levels and other lipid or triglyceride levels and begins in 2005. The organization is calling for the U.S. Preventive Services Task Force and the incoming Secretary of Health and Human Resources to follow the lead of the President’s medical team and expand coverage to methods known to accurately assess abnormal thickening and the build-up of artery clogging plaque in human arteries

“In the long run, non-invasive screening techniques in combination with traditional risk factors are likely to prove more cost-effective in prevention of heart attacks than screening for traditional risk factors, such as high cholesterol and blood pressure, alone” said Dr. P.K. Shah, a SHAPE Task Force member, and director of the Cardiology Division and Atherosclerosis Research Center at Cedars Sinai Medical Center in Los Angeles.


About AEHA

Originated from the Texas Medical Center in Houston, the AEHA is a non-profit organization that promotes education and research related to mechanism, prevention, detection and treatment of heart attacks. The organization is committed to raising public awareness and research funding to support new developments that can lead to eradication of heart attack. The AEHA's mission is to eradicate heart attacks before the end of the century. Additional information is available on the organization's Web site at and

About the SHAPE Task Force:

A group of world-renowned cardiovascular specialists and researchers from around the world have agreed to participate in AEHA’s SHAPE initiative providing their expertise in various areas of cardiovascular science and technology to help prepare a comprehensive guideline cardiovascular screening and prevention of heart attack. A complete list and interview with the Task Force is available on