Advocating more widespread use of certain screening tests, new guidelines from the Screening for Heart Attack Prevention Education (SHAPE) Task Force are far more aggressive than those of the American Heart Association and the National Cholesterol Education Program.

The SHAPE Task Force guidelines recommend coronary calcium scans or ultrasound of the carotids on men between ages 45 and 75 and women between ages 55 and 75, even if they have no symptoms of heart disease. They would omit from screening only those individuals who have no risk factors for coronary disease.

The SHAPE Task Force guidelines point out the value of calcium scans and ultrasound to measure the presence and extent of atherosclerosis. These tests have also proven valuable to predict a person's risk of heart attack and stroke. The task force also advocates more widespread use of other, less commonly used tests such as imaging of the aorta and other large arteries, studies of large artery stiffness, and measurements of cell function in the artery walls.  

Treatment to prevent the development and progression of coronary heart disease would be determined by a combination of these results, plus the presence of conventional heart disease risk factors. The guidelines urge doctors to educate their patients about heart attack prevention at the earliest sign of atherosclerosis.

Although more frequent use of these diagnostic tests would increase costs, the Task Force members argue that wider use of these tests would prevent many heart attacks, strokes and deaths, and the costs associated with angioplasty, bypass surgery, and emergency treatment of heart attack victims.