Heart-Health Screenings

Updated:Oct 15,2013

Recommended Hearth-Health Screenings

The key to preventing cardiovascular disease, also called coronary artery disease (CAD), is managing your risk factors, such as high blood pressure, high total cholesterol or high blood glucose. But how do you know which risk factors you have? The best way to find out is through screening tests during regular doctor visits.

Recommended Screenings image"Regular cardiovascular screening is important because it helps you detect risk factors in their earliest stages,” said Barry A. Franklin, Ph.D., director of Preventive Cardiology and Rehabilitation at William Beaumont Hospital in Royal Oak, Mich., and an American Heart Association volunteer. “This way, you can treat the risk factor with lifestyle changes and pharmacotherapies, if appropriate, before it ultimately leads to the development of cardiovascular disease.”

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 position to begin changing your health in a positive way.

“For many patients, screening results can serve as a wake-up call,” Franklin said. “Higher than optimal cholesterol or body mass index, for example, may drive home the message that it’s time to modify your diet and get more physical activity. When the test comes back and you see abnormal numbers, it becomes personal. Suddenly, the idea of making lifestyle changes isn’t just a recommendation in a pamphlet. It’s something that can impact your life and health.”

All regular cardiovascular screening tests should begin 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. Learn more about these more specific tests at the American Heart Association’s Cardiovascular Conditions website. Even if you haven’t been diagnosed with a condition, your doctor may want more stringent screening if you already have risk factors or a family history of cardiovascular disease.

Here are the key screening tests recommended for optimal cardiovascular health:

Blood Pressure
Blood pressure is one of the most important screenings because high blood pressure has no symptoms so can’t be detected without being measured. High blood pressure greatly increases your risk of heart disease and stroke. If your blood pressure is below 120/80 mm Hg, be sure to get it checked at least once every two years, starting at age 20. If your blood pressure is higher, your doctor may want to check it more often. High blood pressure can be controlled through lifestyle changes or medication. After age 65, women have a higher risk of high blood pressure than men, and African-American adults of all ages have a higher-than-average risk.

Fasting Lipoprotein (cholesterol and triglycerides)
You should have a fasting lipoprotein profile taken every five years, starting at age 20. This is a blood test that measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. (Learn more about cholesterol and triglyceride levels.) You may need to be tested more frequently if:

  • your total cholesterol or HDL cholesterol levels are not at optimal levels, 
  • you have other cardiovascular risk factors, 
  • you’re a man over 45 
  • you’re a woman over 50.

Women tend to have higher triglyceride levels than men. Like high blood pressure, cholesterol and triglycerides can be controlled through lifestyle changes or medication.

Body Weight
During every healthcare visit, your doctor should weigh you to calculate your body mass index and measure your waist circumference. These measurements tell you if you’re at a healthy weight. These screenings should begin at age 20. About two of every three adults are now overweight or obese. This is dangerous because obesity increases blood pressure, triglycerides, total and LDL cholesterol, and can induce diabetes. These risk factors increase your risk of heart disease and stroke.

Blood Glucose
Starting at age 45, you should have your blood glucose level checked at least every three years. High blood glucose levels put you at greater risk of developing type 2 diabetes, which can lead to heart disease and stroke. If you’re overweight AND you have at least one additional cardiovascular risk factor, your doctor may recommend a blood glucose test even if you’re not yet 45.

Smoking, physical activity, diet
If you smoke, tell your doctor at your next healthcare visit. Also discuss your diet and physical activity habits. If you smoke, your doctor can suggest approaches to help quit. If there’s room for improvement in your diet and daily physical activity levels, your doctor will provide helpful suggestions.

Download or print  our quick reference chart

Recommended Schedule for Screening Tests
Recommended ScreeningsHow Often?Starting when?
Blood pressureEach regular healthcare visit or at least once every 2 years if blood pressure is less than 120/80 mm HgAge 20
Cholesterol (“fasting lipoprotein profile” to measure total, HDL and LDL cholesterol, and triglycerides)Every 5 years for normal-risk people; more often if any of the following apply to you:
  • total cholesterol above 200 mg/dL
  • you are a man over age 45 or a woman over age 50
  • your HDL (good) cholesterol is less than 40 mg/dL (if you're a man) or less than 50 mg/dL (if you're a woman)
  • you have other risk factors for heart disease and stroke
Age 20
Weight / Body Mass Index (BMI)Each regular healthcare visitAge 20
Waist circumferenceAs needed to help evaluate cardiovascular riskAge 20
Blood glucose testEvery 3 yearsAge 45
Discuss smoking, physical activity, dietEach regular healthcare visitAge 20

Coronary Heart Disease Risk Factors

Major Risk Factors That Can’t Be Changed

  • Increasing Age: About 82 percent of people who die of coronary heart disease are 65 or older.
  • Male Sex (Gender): Men have a greater risk of heart attack than women do, and they have attacks earlier in life.
  • Heredity (Including Race): Children of parents with heart disease are more likely to develop it themselves.

Major Risk Factors That Can Be Modified, Treated or Controlled

  • Tobacco Smoke: Smokers' risk of developing coronary heart disease is 2-4 times that of nonsmokers.
  • High Blood Cholesterol: As blood cholesterol rises, so does risk of coronary heart disease.
  • High Blood Pressure: High blood pressure increases the heart's workload, causing the heart to thicken and become stiffer.
  • Physical Inactivity: An inactive lifestyle is a risk factor for coronary heart disease. 
  • Obesity and Overweight: People who have excess body fat — especially if a lot of it is at the waist — are more likely to develop heart disease and stroke.
  • Diabetes: Diabetes seriously increases your risk of developing cardiovascular disease.

Other Factors That Increase Cardiovascular Risk

  • Stress: Individual response to stress may be a contributing factor.
  • Alcohol: If you drink, limit your alcohol consumption to no more than two drinks per day for men and no more than one drink per day for women.
  • Diet and Nutrition: A healthy diet is one of the best weapons you have to fight cardiovascular disease.


Learn more:

*This content was last reviewed on 6/23/2011.

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