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Beware of 'heart test' hype this American Heart Month

February is American Heart Month. It’s the time of year when we get a steady stream of advice about keeping our heart healthy.

And for good reason. Cardiovascular disease (essentially, heart attacks and stroke) claims 800,000 lives each year in the United States, making it our leading cause of death, according to the Centers for Disease Control and Prevention (CDC).

But, as two Reuters reporters warn in an article published last week, beware of hype this Heart Month, particularly around the issue of screening tests:

Doctors may suggest a screening test to make sure cardiovascular health is in top shape. But if a person lacks symptoms — like chest pain or shortness of breath — they might want to hit pause for a second and look closer at the costs and benefits.

The fact is, there is no good evidence that any of the common tests are that helpful if a person is symptom-free.

“If you do a test like a stress test in someone who doesn’t have any symptoms, then you are more likely to get a false-positive test than a true positive,” said Dr. Malissa Wood, a spokesperson for the American Heart Association.

Such false alarms trigger more unnecessary tests, which often carry significant risks. …

The government-backed U.S. Preventive Services Task Force also advises against routine screening for heart disease for people at low risk.

Even for those at higher risk — like smokers, diabetics and the obese — there is insufficient evidence to support routine screening, according to the USPSTF, which bases all of its advice on rigorous science.

Still, groups with ties to drug and heart device makers often recommend the tests routinely, and several companies promote them, to the chagrin of experts in the field.

Reuters reporters Frederik Joelving and Genevra Pittman then provide a brief guide to the five most common heart tests given unnecessarily, which are:

  • Stress test (including the “nuclear” version done with radioactive dye injected into the bloodstream)

A healthy lifestyle is key

So, what should you be doing during American Heart Month (and throughout the rest of the year) to keep your heart healthy?

“Experts say the best way to prevent heart disease has little to do with technology and everything to do with lifestyle,” write Joelving and Pittman.

One of those experts is Dr. Rita Redberg, a cardiologist at the University of California, San Francisco. "Tests do not prevent heart disease,” she told the Reuters reporters. “To prevent heart disease, women (and men) should eat healthy diets with lots of fruits and vegetables, get regular physical activity and not smoke.”

“The American Heart Association also recommends keeping your blood pressure and cholesterol levels under control,” note Joelving and Pittman, “although the USPSTF says there is too little evidence to recommend cholesterol tests” in the absence of other heart disease risks.

You can read the Reuters article here. Consumer Reports published its own report on this topic last September. It found that 44 percent of Americans between the ages of 40 and 60 had received at least one heart-specific screening test even though they had no symptoms or risk factors for heart disease.

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