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 or blood glucose. But how do you know which risk factors you have? Your healthcare provider 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 some cardiovascular screening tests 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. Even if you haven’t been diagnosed with a condition, your healthcare provider may want more stringent screening if you already have risk factors or a family history of cardiovascular disease.
Here are the key screening tests for monitoring cardiovascular health:
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 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 and/or medication.
Fasting Lipoprotein Profile (cholesterol)
You might have a fasting lipoprotein profile taken every four to six years, starting at age 20. This is a blood test that measures total cholesterol, LDL (bad) cholesterol and HDL (good) cholesterol. You may need to be tested more frequently if your healthcare provider determines that you’re at an increased risk for heart disease or stroke. After age 40, your health care provider will also want to use an equation to calculate your 10-year risk of experiencing cardiovascular disease or stroke. You can check your numbers using AHA’s Check. Change. Control. Calculator to start the conversation with your health care team.
Like high blood pressure, often cholesterol can be controlled through lifestyle changes and/or medication.
Your healthcare provider may ask for your waist circumference or use your body weight to calculate your body mass index (BMI) 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.
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 overweight AND you have at least one additional cardiovascular risk factor, your healthcare provider may recommend a blood glucose test. Your healthcare provider may also measure glycated hemoglobin A1c levels (A1c %) 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 healthcare provider at your next healthcare visit about approaches to help quit. Also discuss your diet and physical activity habits. If there’s room for improvement in your diet and daily physical activity levels, ask your healthcare provider to provide helpful suggestions.
|Recommended Screenings||How Often?|
|Blood pressure||Each regular healthcare visit or at least once per year if blood pressure is less than 120/80 mm Hg|
|Cholesterol (“fasting lipoprotein profile” to measure total, HDL and LDL cholesterol)||Every 4-6 years for normal-risk adults; more often if any you have elevated risk for heart disease and stroke|
|Weight / Body Mass Index (BMI)||During your regular healthcare visit|
|Waist circumference||As needed to help evaluate cardiovascular risk if your BMI is greater than or equal to 25 kg/m2.|
|Blood glucose test||At least every 3 years*|
|Discuss smoking, physical activity, diet||Each regular healthcare visit|
*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 3-year intervals.