Coronary artery disease screening

The American Heart Association (AHA) has guidelines for testing for coronary artery disease (CAD). Several expert groups worked with the American Heart Association in creating these guidelines, which may be different from those your doctor follows. Consult your doctor to determine which guidelines are appropriate for you.

Beginning at age 20. Your doctor should assess your risk factors for heart disease during every routine exam. Risk factors include your family history of early CAD, whether you smoke or are exposed to secondhand smoke, whether you eat a high-saturated-fat diet, your alcohol intake, and your level of physical activity.

During every routine exam—at least every 2 years—a health professional should check your blood pressure, body mass index, and pulse. Based on your risk of high cholesterol and diabetes, your doctor may recommend that you have a cholesterol test and a fasting blood glucose test.

At age 40 and over. Every 5 years, your 10-year risk of developing coronary artery disease should be assessed using a multiple risk factor score. This should be done more frequently if your risk factors change or if you have two or more risk factors. For example, a nonsmoking, nondiabetic 55-year-old man who has a total cholesterol level of 200 mg/dL, an HDL level of 35 mg/dL, and a systolic blood pressure of 135 mm Hg has a 10% risk of developing CAD over the next 10 years. However, a 40-year-old man with the same risk factors but who smokes has the same risk of CAD as the 55-year-old nonsmoker.

Additionally, most doctors recommend that you be tested for coronary artery disease if you are one of the following:

  • Over age 39, have diabetes or more than one risk factor for CAD, and want to start a vigorous exercise program or are going to have major surgery
  • Responsible for the lives of other people as part of your daily life (such as a pilot, bus driver, or sole caregiver for small children)

The U.S. Preventive Services Task Force does not recommend routine screening for coronary artery disease in adults at low risk.1

C-reactive protein (CRP) testing. A type of C-reactive protein (CRP) test may be done to help find your risk for heart problems. The high-sensitivity C-reactive protein (hs-CRP) test measures very low amounts of CRP in the blood. This test may help find your risk for heart problems, especially when it is considered along with other risk factors such as cholesterol, age, blood pressure, and smoking. But the connection between high CRP levels and heart disease risk is not understood very well.

For more information, see the topic Coronary Artery Disease.

Citations

  1. U.S. Preventive Services Task Force (2004). Screening for coronary heart disease: Recommendation statement. Annals of Internal Medicine, 140(7): 569–572. Also available online: http://www.ahrq.gov/clinic/3rduspstf/chd/chdrs.htm.

Last Updated: August 28, 2009

Author: Debby Golonka, MPH

Medical Review: Adam Husney, MD - Family Medicine

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