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Screening tests for heart disease

The tests you need, and those you don't

Last updated: February 2013

The heart-screening tests below are arranged from most to least necessary for most people. The evidence for each has been reviewed by the U.S. Preventive Services Task Force, an independent group supported by the Department of Health and Human Services. The task force determines whether the benefits of each test outweigh its risks, which can include the chance that a falsely positive result will lead to additional, and unnecessary, tests and treatments.

We also considered four other factors: whether evidence has emerged since the task force's report that changes the recommendation; the number of people affected by the form of heart disease detected by the test; the value of the test, including the cost of the test and treatment of any disease if it's detected; and whether a test has benefits beyond its cardiovascular ones.

For details on each heart-screening test, see our Ratings of heart screening tests.

Test: Blood pressure

A reading of your systolic (upper) and diastolic (lower) number at least once a year by a doctor using a blood-pressure cuff.
Best for: Everyone.

Test: Cholesterol

A blood test at least every five years to measure your LDL (bad) and HDL (good) cholesterol levels, as well as your triglycerides, an artery-clogging fat.
Best for: Men 35 and older and women 45 and older who have other coronary risk factors, such as high blood pressure or a history of smoking. For others, the benefits of the test are less certain.

Test: Blood glucose

A blood test at least every three to five years to measure your blood glucose level.
Best for: People at high risk of type 2 diabetes, including those with any of these risk factors: a systolic (upper) blood pressure over 135 or a diastolic (lower) pressure over 80; obesity (with a body mass index of 30 or over); or an LDL (bad) cholesterol over 130. For others, the benefits of the test are less certain.

Test: C-reactive protein

A periodic blood test to measure your CRP level, a marker for inflammation of the arteries, which has been linked to an increased risk of heart attack.
Best for: People at moderate coronary risk, such as those with a high LDL (bad) cholesterol, to determine how aggressively they need to lower their LDL. People at high or low coronary risk probably don't need the test, since the results for them won't affect treatment decisions.

Test: Electrocardiogram (EKG or ECG)

A test that uses electrodes attached to the chest to measure and record electrical activity in the heart and provide information about your heartbeat and heart health.
Best for: People who have symptoms of heart disease, such as chest pain; middle-aged people who are just starting to exercise; and for people 50 and older as a baseline. Other people should generally not get the test for screening purposes.

Test: Exercise stress test

A test that measures the heart's function while it is stressed by exercise or, in some cases, medications.
Best for: People who have symptoms of heart disease, such as chest pain, and middle-aged people who are just starting to exercise. Other people should generally not get the test for screening purposes.

Test: Abdominal aortic aneurysm

An ultrasound of the abdomen that looks for a ballooning of a portion of the aorta, the main artery that carries blood from the heart to the rest of the body. Such aneurysms can be deadly if they burst.
Best for: Anyone who has a detectable lump in his or her abdomen felt by a physician during a physical exam and men 65 and older, especially those who are current or former smokers. Women 65 and older who are long-term smokers or who have a family history of aortic aneurysm migh consider the test, though the benefits for them are less certain. Other people should not get the test for screening purposes.

Test: Peripheral artery disease

A comparison of the blood pressure in your arms with the blood pressure in your legs, using either a blood-pressure cuff or an ultrasound, to look for clogging of the arteries in your legs.
Best for: People who have leg pain while walking, a symptom of clogged peripheral arteries. Other people should generally not get the test for screening purposes.

Test: Carotid artery disease

An ultrasound of the arteries on either side of your neck. Clogging of those arteries can increase the risk of stroke and can be treated with a surgical procedure.
Best for: People who have suffered a stroke or mini stroke (a transient ischemic attack). Other people should not get the test for screening purposes.

Test : CT angiography

A CT scan that takes multiple images of your coronary arteries to produce a three-dimensional picture of the arteries.
Best for: Possibly people who have chest pain and abnormal results on an EKG and exercise stress test, though most of those people probably need standard angiography instead, the gold-standard for diagnosing heart disease. Other people should not get the test for screening purposes.

Heart attack calculator

Click on the image at right to use our heart-attack risk calculator. It can help you determine your risk of developing cardiovascular disease in the next 10 years. Based on your answers, we've also included recommendations to help keep you healthy.

Ratings of heart tests

When it comes to screening tests for heart disease, more is not always better. Some people get tests they don't need while failing to get those they do. Click on the image at right for a tool that will help you choose the tests that are best for you, based on your age, gender, and risk level.

   

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