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U.S. Preventive Services Task Force

Screening for Coronary Heart Disease With Electrocardiography

Clinical Summary of U.S. Preventive Services Task Force Recommendation

Population Asymptomatic adults at low risk for coronary heart disease (CHD) events Asymptomatic adults at intermediate or high risk for CHD events
Recommendation Do not screen with resting or exercise electrocardiography (ECG).
Grade: D
No recommendation.
Grade: I (Insufficient Evidence)
Risk Assessment Several factors are associated with a higher risk for CHD events, including older age, male sex, high blood pressure, smoking, abnormal lipid levels, diabetes, obesity, and sedentary lifestyle. Calculators are available to ascertain a person's 10-year risk for a CHD event.

Persons with a 10-year risk >20% are considered to be high-risk, those with a 10-year risk <10% are considered to be low-risk, and those in the 10%–20% range are considered to be intermediate-risk.

Screening Tests Several abnormalities on resting and exercise ECG are associated with an increased risk for a serious CHD event. However, the incremental information offered by screening asymptomatic adults at low risk for a CHD event with resting or exercise ECG (beyond that obtained with conventional CHD risk factors) is highly unlikely to result in changes in risk stratification that would prompt interventions and ultimately reduce CHD-related events.
Balance of Harms and Benefits The potential harms of screening for CHD with exercise or resting ECG equal or exceed the potential benefits in this population. The USPSTF could not determine the balance between the benefits and harms of screening for CHD with resting or exercise ECG in this population.
Other Relevant USPSTF Recommendations The USPSTF has made recommendations on screening for carotid artery stenosis, high blood pressure, lipid disorders, peripheral arterial disease, and obesity. These recommendations are available at http://www.uspreventiveservicestaskforce.org.

For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.

Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

AHRQ Publication No. 11-05158-EF-3
Current as of July 2012

Internet Citation:

U.S. Preventive Services Task Force. Screening for Coronary Heart Disease With Electrocardiography: Clinical Summary of USPSTF Recommendation. AHRQ Publication No. 11-05158-EF-3. July 2012. http://www.uspreventiveservicestaskforce.org/uspstf11/coronarydis/chdsum.htm


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