Using nontraditional risk factors in coronary heart disease risk assessment: U.S. Preventive Services Task Force recommendation statement.

The researchers reviewed studies of adults without heart disease symptoms. They looked at three extra tests: ankle-brachial index, which compares blood pressure in the ankle and arm; high-sensitivity C-reactive protein, a blood marker of inflammation; and coronary artery calcium scans, CT scans that look for calcium in heart arteries. The review found too little evidence to know whether adding these tests to usual factors, such as age, smoking, blood pressure, cholesterol, and diabetes, prevents heart attacks or deaths. Calcium scans can involve radiation and may lead to more tests, while the benefits and harms of the other tests were also unclear.

What this means for you: This does not support routinely buying or requesting these extra tests if you have no symptoms. Ask a clinician about them only if your usual risk assessment leaves an important decision uncertain.