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
The American Heart Association and the Centers
for Disease Control and Prevention (CDC) have released recommendations for a
C-reactive protein (CRP) blood test. An increase in
CRP levels is associated with inflammation in the blood vessels,
atherosclerosis, and increased risk of coronary artery
disease and
heart attack.2
The AHA/CDC panel recommends that a CRP test be done on some people who
are at risk for developing coronary artery disease.3
If you have any CAD risk factors, ask your doctor whether a CRP test might help
detect CAD early.
For more information, see the topic Coronary
Artery Disease.
