Recommendation

The USPSTF recommends against using ECG, exercise testing, or CT scanning to screen low-risk adults for CHD. Evidence is insufficient to recommend these techniques even for adults at increased risk (USPSTF, 2004). AAFP does not recommend routine ECG in asymptomatic children or adults as part of a periodic health examination (Pignone et al., 2003). USPSTF concluded that the evidence is insufficient for the use of nontraditional risk factors to screen asymptomatic men and women. They recommend against screening for asymptomatic CAS in the general adult population. USPSTF recommends the use of aspirin for men age 45 to 79 years and women age 55 to 79 when the potential benefit from a reduction in MIs or strokes, respectively, outweighs the potential harm from an increase in gastrointestinal hemorrhage (Table 6-5). It is important to discuss both the benefits and the harms with patients. Aspirin in younger men and women is not recommended because they are likely to experience more harm than benefit. There is no evidence to use aspirin for cardiovascular disease prevention in average-risk men and women 80 years or older (USPSTF, 2009).

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