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 .
Association of Exercise-Induced, Silent ST-Segment Depression With the Risk of Stroke and Cardiovascular Diseases in Men
Background and Purpose — There are few if any data on the prognostic importance of silent myocardial ischemia during exercise with regard to the risk of stroke and cardiovascular diseases ( CVDs ) among asymptomatic men . In this prospect i ve study , we investigated the relation of silent myocardial ischemia and the risk of stroke and CVD death in men with and without conventional risk factors . Methods — The study sample included 1726 middle-aged men with no history of stroke , coronary heart disease , or atrial fibrillation at baseline . Silent myocardial ischemia was defined as a horizontal or downsloping ST-segment depression ( ⪖1 mm ) during exercise electrocardiography . A total of 86 CVD-related deaths and 78 strokes occurred during an average follow-up of 10 years . Results — Men with silent ischemia during exercise  had a 3.5-fold increased risk of CVD death and a 2.2-fold increased risk of stroke compared with men without silent ischemia , after adjusting for conventional risk factors . Silent ischemia during exercise was associated with a 3.8-fold ( 95 % confidence interval [ CI ] , 1.5 to 9.5 ) increased risk for CVD in smokers , a 3.9-fold ( 95 % CI , 2.1 to 7.3 ) increased risk in hypercholesterolemic subjects , a 3.6-fold ( 95 % CI , 1.9 to 6.8 ) increased risk in the hypertensives , and 3.8-fold ( 95 % CI , 2.0 to 7.1 ) increased risk in overweight men . The respective relative risks for stroke were 3.8 ( 95 % CI , 1.1 to 12.5 ) , 3.5 ( 95 % CI , 1.7 to 7.4 ) , 3.4 ( 95 % CI , 1.6 to 7.1 ) , and 2.9 ( 95 % CI , 1.4 to 6.1 ) . Conclusions — Exercise-induced silent myocardial ischemia is an important indicator of increased risk of stroke and CVD in men with other risk factors , such as smoking , hypercholesterolemia , hypertension , and being overweight
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 .