Heart-Health Screenings

An important aspect of lowering risk of cardiovascular disease, also called coronary artery disease (CAD), is managing health behaviors and risk factors, such as diet quality, physical activity, smoking, body mass index (BMI), blood pressure, total cholesterol, blood glucose and sleep quality. But how do you know which risk factors you have? Your health care professional may conduct or request screening tests during regular visits.

Few of us have ideal risk levels on all screening tests. However, if you do have test results that are less than ideal, it doesn’t mean you’re destined to develop a serious cardiovascular disease. On the contrary, it means you’re in a position to begin changing your health in a positive way.

Some measurements such as body weight and blood pressure are taken during routine medical appointments and cholesterol screening begins at age 20. The frequency of follow up will depend on your level of risk.

You will probably require additional and more frequent testing if you’ve been diagnosed with a cardiovascular condition such as heart failure or atrial fibrillation, or if you have a history of heart attack, stroke or other cardiovascular events. Even if you haven’t been diagnosed with a condition, your health care professional may want more stringent screening if you already have risk factors or a family history of cardiovascular disease.

Key screening tests for monitoring cardiovascular health:

Blood pressure

Blood pressure is one of the most important screenings because high blood pressure usually has no symptoms so it can’t be detected without being measured. High blood pressure greatly increases your risk of heart disease and stroke. If your blood pressure is normal with values below 120/80 mm Hg, be sure to get it checked once a year, If your blood pressure is higher, your health care professional may want to check it more often. High blood pressure can be controlled through lifestyle changes and/or medication.

Cholesterol

In adults who are 20 or older and not on lipid-lowering therapy, measurement of either a fasting or nonfasting plasma lipid profile is effective in estimating cardiovascular disease risk. This is a blood test that measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. You may need to be tested more frequently if your health care professional determines that you’re at an increased risk for heart disease or stroke. After age 40, your health care professional will also want to use an equation to calculate your 10-year risk of experiencing cardiovascular disease or stroke.

Like high blood pressure, often cholesterol can be controlled through lifestyle changes and/or medication.

Body weight

Your health care professional may ask for your waist circumference or use your body weight to calculate your body mass index during your routine visit. These measurements may tell you and your physician whether you’re at a healthy body weight and composition. Being obese puts you at higher risk for health problems such as heart disease, stroke, atrial fibrillation, congestive heart failure and more.

Blood glucose

High blood glucose, or "blood sugar" levels, put you at greater risk of developing insulin resistance, prediabetes and type 2 diabetes. Untreated diabetes can lead to many serious medical problems including heart disease and stroke. If you’re 45 years or older or if you’re overweight AND you have at least one additional cardiovascular risk factor regardless of age, your health care professional may recommend a blood glucose test. They may also measure glycated hemoglobin A1C levels in your blood to screen for Type 2 diabetes. An A1C level of 6.5% or higher is used to define diabetes.

Smoking, physical activity, diet

If you smoke, talk to your health care professional at your next office visit about ways to help you quit. Also discuss your diet and physical activity. If there’s room for improvement in your diet and daily physical activity levels, ask your health care professional for helpful suggestions.

*The American Diabetes Association recommends testing for prediabetes and risk for future diabetes for all people beginning at age 45 years. If tests are normal, it is reasonable to repeat testing at a minimum of three-year intervals.