With heart disease being the leading cause of death in the USA, the goal is to identify risk factors earlier and manage your heart health over time before any complications develop.
With heart disease being a
A key goal of screening is to identify risk factors for heart disease early, so you and your healthcare team can establish a plan to protect your heart health and prevent or minimize any heart complications before they develop.
The
This can be done at your annual physical exam by your primary care doctor.
They may do a number of different types of screening, from asking questions to reviewing your medical history and performing or ordering specific diagnostic tests.
The goal of these tests is to assess how likely you are to develop heart disease, based on various risk factors. The
- high blood pressure
- high cholesterol
- diabetes
- a family history of heart disease
- overweight and obesity
- current or past smoking habits
- eating style high in added sugars, sodium, and saturated or trans fats
- physical inactivity
- excessive alcohol drinking
Routine screening includes several different types of tests to assess these factors and inform your healthcare team about your heart health.
Medical history
A detailed medical history can help your doctor identify certain factors that may increase your likelihood of developing heart disease.
When reviewing your medical history, a healthcare professional may ask questions about your physical activity levels, dietary patterns, past or present smoking habits, and alcohol use. Your doctor should also ask about your current lifestyle habits at each visit.
Physical exam
A physical exam can help your doctor measure and monitor other factors that may contribute to your risk of heart disease. This may include blood pressure monitoring and weight measurements, but those can also be more extensive tests they order.
High blood pressure, or hypertension, is one of the
Regular blood pressure monitoring at least once a year can provide you and your healthcare team a chance to act early if your levels get too high. This can reduce the likelihood of developing potentially severe complications.
A healthcare professional monitors your blood pressure using an inflatable cuff that they wrap around your arm. They inflate and then deflate the cuff while measuring your blood pressure.
Blood pressure readings are measured in millimeters of mercury (mm Hg). The measurements are divided into categories based on your systolic (upper) and diastolic (lower) readings:
| Category | Systolic reading | Diastolic reading |
|---|---|---|
| Standard | lower than 120 mm Hg | lower than 80 mm Hg |
| Elevated | 120–129 mm Hg | less than 80 mm Hg |
| High Blood Pressure – Stage 1 | 130–130 mm Hg | 80–89 mm Hg |
| High Blood Pressure – Stage 2 | 140 mm Hg or higher | 90 mm Hg or higher |
Blood pressure readings are often expressed as the systolic number “over” the diastolic number, such as “120 over 80” for a standard blood pressure reading.
Any blood pressure reading that is 180 over 120 mm Hg is known as a hypertensive crisis and requires immediate medical attention.
A physical exam also typically includes an assessment of body weight. A healthcare professional will use your body weight and your height to calculate your body mass index (BMI).
While weight and BMI are not direct indicators of heart health, people with overweight or obesity tend to be more likely to develop health complications, including heart disease.
BMI readings fall into four main categories:
| Category | Measurement |
|---|---|
| Underweight | BMI less than 18.5 |
| Standard | BMI between 18.5–24.9 |
| Overweight | BMI between 25.0–29.9 |
| Obesity | BMI 30.0 or more |
In addition, or as an alternative, your doctor may measure your
Higher levels of body fat around the abdomen are linked to greater amounts of fat in the liver. This can cause liver disease and in turn increase the likelihood of developing heart disease.
A high waist circumference is linked to a
| Category | Measurement |
|---|---|
| Healthy waist circumference for men | less than 40 inches |
| Healthy waist circumference for non-pregnant women | less than 35 inches |
High cholesterol levels in the blood can build up in the arteries, making it harder for blood to flow through. If too much cholesterol builds up in the arteries, a clot can form. This causes them to become blocked, leading to a heart attack or stroke.
Cholesterol is produced by the body in the liver, but we get extra cholesterol from the food we eat. If your cholesterol levels are too high, your doctor may suggest a change to your diet or prescribe medication to lower them.
A simple blood test can measure your:
- HDL (good) cholesterol
- LDL (bad) cholesterol
- triglycerides
Work with your doctor to discuss your readings and whether or not they’re in a standard range.
Fasting cholesterol levels should be taken every 4 to 6 years. Your doctor may suggest more frequent testing if you are considered at higher risk for heart disease.
High levels of glucose in the blood can increase the likelihood of developing insulin resistance, which can lead to prediabetes or type 2 diabetes.
Both of these conditions can cause heart health concerns. High glucose levels in the blood can also damage the blood vessels, causing clots and clogged blood vessels.
A simple blood test can determine your glucose readings, which are measured in milligrams per deciliter (mg/dL).
| Category | Measurement |
|---|---|
| Normal A1C Results | less than 5.7% |
| Normal Fasting Blood Sugar Results | less than or equal to 99 mg/dL |
| Normal Glucose Tolerance Results | less than or equal to 140 mg/dL |
Numbers above these readings may be a sign of prediabetes or diabetes.
Blood glucose testing is recommended every 3 years starting at age 45, but your healthcare professional may want to test sooner or more often if you have certain risk factors for heart disease.
If regular testing shows that you have early signs of heart disease or may be more likely to develop heart disease, your doctor may suggest additional testing to evaluate your heart health.
Some of these may be done by your primary care doctor, whereas others may be performed by a heart specialist known as a cardiologist.
An electrocardiogram, also known as an ECG or EKG, is used to detect any atypical rhythms in the way your heart beats.
In this test, a healthcare professional will attach patches with electrode sensors to your chest, arms, and legs. These sensors will monitor the electrical activity of your heart.
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Your doctor may also use an ECG to perform a stress test. The goal of stress testing is to determine how well your heart works under stress. If you are unable to exercise, your doctor may prescribe a medication to make your heart beat faster.
Work with your healthcare professional to discuss the results of any heart monitoring and what they mean for your health.
An echocardiogram is a type of ultrasound scan that healthcare professionals use to see the structure of your heart. By capturing a video of your heart, your doctor can check its size and shape, as well as how all of the different chambers and valves are working.
Your doctor may use various other noninvasive imaging techniques to examine your heart, including a chest X-ray, CT scan, or MRI scan.
Another test is the coronary artery calcium score, which is a CT image of the heart to determine the amount of calcium buildup in the coronary arteries.
This can be a tool to help determine risk and screen for related heart disease. It can also help your healthcare team guide decision-making for medications, possibly for lowering cholesterol or heart disease prevention. This screening is also recommended for adults 40 years and older without any symptoms who may be more at risk for heart disease.
If results from other tests indicate you have heart disease, a cardiologist may recommend a coronary angiogram to study how blood is flowing through your heart.
In this procedure, a healthcare professional inserts a catheter through a blood vessel in your arm or groin and threads it to the heart. Once in the heart, a dye is injected, and a special X-ray is used to visualize blood flow.
Healthcare professionals can also use an angiogram to take tissue samples of the heart and perform minor surgical procedures if needed.
Your doctor will go over the results from any heart imaging that’s performed and what they mean.
Genetic testing isn’t typically part of a heart workup. However, some people who may be more likely to develop heart disease
Genetic testing may be recommended for people who are more likely to develop certain types of heart disease that are known to be inherited, such as hypertrophic cardiomyopathy (HCM). People with a first-degree relative who has been diagnosed with HCM should discuss genetic testing with their healthcare professional.
Talk with your doctor about your family history of heart disease and whether you would benefit from genetic testing. If you do undergo genetic testing, your doctor can also discuss the results and what they may mean for your health.
Heart disease comes in many forms and can have serious effects on your health. Regular testing can help you identify any potential issues early, allowing you to get a diagnosis and take the necessary steps to protect your health.