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Panel advises against certain routine heart tests for low-risk adults

Patient Safety Monitor Alert, February 25, 2004

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Low-risk adults who show no signs of heart disease should not be subjected to treadmill exercise testing, resting electrocardiograms (EKG), or electron beam computerized tomography (EBCT), the U.S. Preventive Services Task Force will recommend in the April 6 issue of the Annals of Internal Medicine (Vol. 140, No. 7).

Although treadmill testing, EKG, and EBCT can identify whether someone has a higher risk of heart disease, they can actually do more harm than good in patients with a low-risk for the disease because of the frequency of false-positive and false-negative results, the task force concludes. In addition, no studies exist that show whether the tests can improve health outcomes.

False-positive results often lead to unnecessary medications, invasive and potentially dangerous tests, such as coronary angiography, and can cause the patient to suffer psychological stress and anxiety. False-negative results can mislead those with heart disease and result in delayed treatment.

The task force does recommend that physicians screen patients for many of the risks that can lead to heart disease, such as high blood pressure, high cholesterol, obesity, and diabetes.

Adults who are at low-risk for heart disease include men under age 50 and women under age 60 who have normal blood pressure and cholesterol levels, do not smoke, and do not have diabetes.

Click here for a calculator that allows one to estimate one's risk of heart disease.

The Task Force, sponsored by the Agency for Healthcare Research and Quality, is the leading independent panel of private-sector experts in prevention and primary care and conducts rigorous, impartial assessments of the scientific evidence for a broad range of preventive services.

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