New guidelines from the U.S. Preventive Services Task Force do not recommend use of treadmill exercise testing, resting electrocardiograms, or electron beam computerized tomography to screen for heart disease in asymptomatic, low-risk adults, according to an article in the February 17th issue of Annals of Internal Medicine. For adults at higher risk for heart disease, the Task Force found insufficient evidence for or against using these three tests for screening.

An estimated 22 million Americans have heart disease, and more than 700,000 die from it each year. Heart disease is the leading killer of both men and women and is estimated to cost more than $350 billion annually in medical care, time lost from work, and other expenses.

Men under age 50 years and women under age 60 years who have normal blood pressure and cholesterol levels, do not smoke, and do not have diabetes are considered at low risk of heart disease. A simple calculator to estimate risk of heart disease can be found at http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=pub.

The Task Force recommends screening for many of the risks for heart disease, such as hypertension, obesity, diabetes, and high cholesterol levels. Although treadmill testing, electrocardiography, and electron beam computed tomography could identify persons at higher risk of heart disease, no studies to date have examined whether or not using these tests to screen adults improves health outcomes. Furthermore, the Task Force concluded that using the three technologies to screen for heart disease in low-risk adults could cause more harm than good because of the frequency of false-positive and false-negative results.

The Task Force said that the evidence is inadequate to determine how test results would change the course of treating patients and noted concern that potential harms, such as false-positive findings, unnecessary invasive procedures, and over-treatment could outweigh any benefit of the tests in lower risk persons.

"These recommendations can help clinicians and their patients make more informed decisions about use of these tests to screen for heart disease and may help guide employers and insurers as well," said Task Force chair, Ned Calonge, MD. "The most important thing individuals at low risk can do is to work with their clinician to monitor their blood pressure, cholesterol, and weight, and to be physically active."