“Despite widespread testing for high levels of cholesterol and blood pressure, heart disease is a silent killer that often strikes individuals who have not been identified as at risk. In 30 percent to 50 percent of patients with severe hardening of the arteries, their first symptom is an acute, often fatal, heart attack. Medicine ought to be able to do better at detecting this disease and helping patients keep it from progressing. Two imaging scans that would provide more evidence of early trouble were touted for more routine use recently in a supplement to the American Journal of Cardiology. The supplement raised eyebrows in medical-ethics circles because it was financially supported by Pfizer Inc., which makes a popular cholesterol-lowering drug, Lipitor. … The supplement’s physician-authors believe it would, and propose age and risk-category guidelines that would qualify 50 million Americans for testing, at a cost pegged between $250 and $750 for both scans. Before society makes that large an investment, however, it should have better evidence to go on, and this is the real problem.” (07/30/06)