Clinical Summary
Cardiovascular Disease Risk: Screening With Electrocardiography
June 12, 2018
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.
| Population | Adults at low risk of CVD events | Adults at intermediate or high risk of CVD events |
|---|---|---|
| Recommendation | Do not screen with resting or exercise ECG. Grade: D |
No recommendation. Grade: I (Insufficient evidence) |
| Risk Assessment | Risk factors for CVD events include older age, male sex, high blood pressure, current smoking, abnormal lipid levels, diabetes, obesity, and physical inactivity. Several calculators and models are available to quantify a person's 10-year risk of CVD events; the USPSTF recommends that clinicians use the Pooled Cohort Equations to assess CVD risk. | |
| Screening Tests | Resting ECG records cardiac electrical activity while the patient is at rest, over a short period. Exercise ECG records cardiac electrical activity during physical exertion, often at a prespecified intensity level. The most common method of exercise ECG is the treadmill test. Both resting and exercise ECG look for markers of previous myocardial infarction, myocardial ischemia, and other cardiac abnormalities (such as left ventricular hypertrophy, bundle branch block, or arrhythmia) that may be associated with CVD or predict future CVD events. | |
| Treatments | Asymptomatic adults at increased risk of CVD events are usually treated with a combination of diet and exercise modifications, lipid-lowering medications, aspirin, hypertension management, and interventions to encourage tobacco cessation. | |
| Other Relevant USPSTF Recommendations | The USPSTF has made recommendations on many factors related to CVD prevention, including screening for high blood pressure, use of statins, counseling on smoking cessation, and counseling to promote healthful diet and physical activity. In addition, the USPSTF recommends low-dose aspirin use in certain persons at increased risk of CVD events. | |
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.