Evidence on harms was limited , but direct harms seemed minimal ( for resting ECG ) or small ( for exercise ECG ) .
BACKGROUND Coronary heart disease is the leading cause of death in adults .
Screening for abnormalities by using resting or exercise electrocardiography ( ECG ) might help identify persons who would benefit from interventions to reduce cardiovascular risk .
PURPOSE To up date the 2004 U.S. Preventive Services Task Force evidence review on screening for  resting or exercise ECG abnormalities in asymptomatic adults .
Major risk factors as antecedents of fatal and nonfatal coronary heart disease events.
CONTEXT A frequently cited concept is that individual major risk factors for coronary heart disease ( CHD ) are absent in many patients ( perhaps > 50 % ) with CHD . However , prior studies have not systematic ally evaluated the extent to which CHD patients have previous exposure to at least 1 risk factor , including diabetes , cigarette smoking , or clinical ly elevated levels of cholesterol or blood pressure . OBJECTIVE To determine the frequency of exposure to major CHD risk factors . DESIGN , SETTING , AND PARTICIPANTS Three prospect i ve cohort studies were included : the Chicago Heart Association Detection Project in Industry , with a population sample of 35 642 employed men and women aged 18 to 59 years ; screenees for the Multiple Risk Factor Intervention Trial , including 347 978 men aged 35 to 57 years ; and a population -based sample of 3295 men and women aged 34 to 59 years from the Framingham Heart Study ( FHS ) . Follow-up lasted 21 to 30 years across the studies . MAIN OUTCOME MEASURES Fatal CHD in all cohorts and nonfatal myocardial infa rct ion ( MI ) in the FHS , compared by exposure to major CHD risk factors , defined as total cholesterol of at least 240 mg/dL ( > or = 6.22 mmol/L ) , systolic blood pressure of at least 140 mm Hg , diastolic blood pressure of at least 90 mm Hg , cigarette smoking , and diabetes . Participants were stratified by sex and age ( 18 - 39 vs 40 - 59 years ) . RESULTS For fatal CHD ( n = 20 995 ) , exposure to at least 1 clinical ly elevated major risk factor ranged from 87 % to 100 % . Among those aged 40 to 59 years at baseline with fatal CHD ( n = 19 263 ) , exposure to at least 1 major risk factor ranged from 87 % to 94 % . For nonfatal MI , prior exposure was documented in 92 % ( 95 % CI , 87%-96 % ) ( n = 167 ) of men aged 40 to 59 years at baseline and in 87 % ( 95 % CI , 80%-94 % ) ( n = 94 ) of women in this age group . CONCLUSIONS Antecedent major CHD risk factor exposures were very common among those who developed CHD , emphasizing the importance of considering all major risk factors in determining CHD risk estimation and in attempting to prevent clinical CHD . These results challenge cl aims that CHD events commonly occur in persons without exposure to at least 1 major CHD risk factor
Evidence on harms was limited , but direct harms seemed minimal ( for resting ECG ) or small ( for exercise ECG ) .
BACKGROUND Coronary heart disease is the leading cause of death in adults .
Screening for abnormalities by using resting or exercise electrocardiography ( ECG ) might help identify persons who would benefit from interventions to reduce cardiovascular risk .
PURPOSE To up date the 2004 U.S. Preventive Services Task Force evidence review on screening for  resting or exercise ECG abnormalities in asymptomatic adults .