Checking for clogged arteries doesn’t help inveterate smokers kick the habit if they are already in a quit-smoking program, Swiss researchers have found.

Yet that’s sometimes the justification when doctors recommend the expensive scan, called carotid plaque screening, which experts say has no proven benefits in people without symptoms of heart disease.

“When people get a very good smoking cessation program, carotid plaque screening does not add anything,” Dr. Nicolas Rodondi, who led the new study, told Reuters Health.

Some previous research had suggested that showing people dire pictures of cholesterol buildup, or plaque, in their arteries might be the stick they need to make healthy changes to their lifestyle.

But at least for smokers, the new study slashes those hopes.

“It proves that in trying to motivate smokers to quit, this strategy is not going to be useful,” said Dr. Patrick O’Malley of the Uniformed Services University in Bethesda, Maryland, who wrote an editorial about the findings.

During carotid plaque screening, doctors use ultrasound to get a picture of the arteries that supply blood to the brain. The procedure is gaining popularity both in the U.S. and in Europe, but it’s not clear that it actually helps patients.

“There is absolutely no proven benefit,” O’Malley told Reuters Health. “It’s still a promising test, but it is being overutilized in practice.”

While some organizations currently recommend the routine carotid plaque screening, the government-backed U.S. Preventive Services Task Force advises against it when people have no symptoms of heart disease.

Scans vs. counseling

The new study, published in the Archives of Internal Medicine, is based on more than 500 long-time smokers aged 40 to 70 who all wanted to quit and had no symptoms of heart disease.

All of them had six sessions of counseling over a year, plus a phone call, nicotine patches and brochures on smoking cessation. In addition, half were randomly chosen to be screened for carotid plaque, which most turned out to have.

Although smoking contributes to plaque, which is a risk factor for heart attack and stroke, the ultrasound pictures didn’t seem to have any effect.

After one year, a quarter of those who got screened had been smoke-free for at least a week based on their own reports as well as breath analyses. for those who didn’t get screened, the number was 22 percent — a difference that could easily be chalked up to chance.

And whether or not people had plaques visible on the scans didn’t make a difference either.

“Smokers are a different breed, they tend to have a different psychological profile,” said O’Malley. “They are more recalcitrant.”

According to Rodondi, carotid artery screening costs $400 in Switzerland — about the same as six sessions of quit-smoking counseling with a doctor.

And while the scan may not be worth its price tag, the smoking cessation program is, he added.

“We are very successful with the smoking cessation program,” Rodondi told Reuters Health. “When smokers try to stop smoking by themselves they only get a five-percent smoking cessation rate at one year.”

In an earlier study, O’Malley found that heart scans don’t seem to be of much help in changing risk factors for heart disease either.

While he said it’s still possible that medical scans might motivate some non-smokers to lead healthier lives, he said the new technology mostly distracts from establishing a good rapport between doctors and smokers — something that might ultimately help them kick the habit.

“It’s just difficult — It’s an addiction,” O’Malley said. “But I think people underestimate the value of building a relationship with patients and a longitudinal plan.”

Latest Depression News

TUESDAY, Feb. 8 (HealthDay News) — People whose genetic make-up produces lower levels of a brain molecule called neuropeptide Y (NPY) may be at increased risk for major depression, says a new study.

Previous research has shown that NPY helps people calm down after experiencing stressful events.

This study found that when exposed to negative stimuli, people with gene variations that cause them to produce lower levels of NPY have stronger responses in key brain circuits related to emotion. this means they have less resilience to stress and a stronger psychological response to pain; they were also overrepresented in a population diagnosed with a major depressive disorder, the researchers said.

The study was published Feb. 7 in the Archives of General Psychiatry.

“We’ve identified a biomarker — in this case genetic variation — that is linked with increased risk of major depression,” senior author Dr. Jon-Kar Zubieta, a professor of psychiatry and radiology, and a research professor at the University of Michigan Molecular and Behavioral Neurosciences Institute, said in a university news release.

“This appears to be another mechanism, independent of previous targets in depression research, such as serotonin, dopamine and norepinephrine,” he added.

In the study, researchers used functional magnetic resonance imaging (fMRI) to look at the brain activity of participants as they read neutral words (such as “material”) negative words (“murderer”) or positive words (“hopeful”).

Participants who had lower NPY levels showed lots of activity in the prefrontal cortex, which is involved with processing emotion, compared to those with higher NPY levels.

“This tells us that individuals with the risk-associated NPY gene variant tend to activate this key brain region more than other people, even in the absence of stress and before psychiatric symptoms are present,” said lead study author Dr. Brian Mickey, an assistant professor of psychiatry at the University of Michigan Medical School.

Researchers then injected participants’ jaw muscles with a saline solution that causes brief moderate pain. the level of pain was adjusted for each person until they rated it a 4 on a 10-point scale.

Participants were asked to describe how they felt before and after the injection. Participants in the low NPY group reported more negative emotions both before and after the injection, suggesting they were more emotionally affected while both anticipating and thinking about the painful experience later.

The finding may eventually help with early diagnosis and treatment for depression, including individualized therapies based on a patient’s genetic profile, the researchers said.

– Robert Preidt

Copyright © 2011 HealthDay. All rights reserved.

SOURCE: University of Michigan Health System, news release, Feb. 7, 2011