Coronary artery disease screening
The American Heart Association has released new guidelines for screening for coronary artery disease (CAD). Several expert groups worked with the American Heart Association in creating these guidelines. These guidelines are generally followed in Canada, but they may be different from those your doctor follows. Work with your doctor to determine which guidelines are best for you.
Beginning at around age 20. Your doctor should assess your risk factors for heart disease during every routine examination. Risk factors include your family history of CAD, whether you smoke or are exposed to second-hand smoke, whether you eat a diet high in saturated-fat, how much alcohol you drink, and your level of physical activity.
During every routine examination—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, you should have a fasting lipoprotein analysis to measure your total and HDL cholesterol, and a fasting blood glucose test. If risk factors are present, these tests should be done every 2 years. If you don't have risk factors, these tests should be done every 5 years.
At age 40 and over. Every 5 years, your 10-year risk of developing coronary artery disease should be checked 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 non-smoking, non-diabetic 55-year-old man who has a total cholesterol level of 5.2 mmol/L (200 mg/dL), an HDL level of 0.9 mmol/L (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 non-smoker.
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 American Heart Association and the U.S. 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.1
The AHA/CDC panel recommends that a CRP test be done on some people who are at risk for developing coronary artery disease.2 If you have any CAD risk factors, ask your doctor whether a CRP test might help detect CAD early.
In Canada, CRP tests for heart or vascular problems currently are only used in research studies and at major medical centres and are not yet widely available.
For more information, see the topic Coronary Artery Disease.
| Author: | Douglas Dana Robin Parks, MS | Last Updated: September 21, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology Robert A. Kloner, MD, PhD - Cardiology Ruth Schneider, MPH, RD - Diet and Nutrition | |
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