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Are You at Risk for Heart Disease?

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These key screening tests can help you prevent heart disease

Many of us don't realize that we're at risk for heart disease, but simple routine screening tests can make it easier to catch heart problems sooner — or prevent them altogether.

There are some screening tests that everyone should have starting at age 20. These include a measure of waist circumference and body mass index, blood pressure measurements, blood tests to screen for diabetes and high cholesterol levels, and a “reset” on the decision to smoke for those who do so at that age.

The timing and frequency of other tests may depend on a person’s family health history or symptoms. If you're not sure what you need or where to start, here's a look at the screening tests that cardiologists like myself recommend. The results will give you and your primary care doctor important information about your baseline heart health. Together, you can use this knowledge to manage your risk factors and help protect your heart.

Blood pressure test

Blood pressure tests check the pressure in your arteries as your heart pumps blood around your body. The tests are quick, easy, and are typically performed — using an inflatable cuff placed around your arm — every time you visit the doctor.

When you need it: At least once every two years beginning at age 20. You may need to have your blood pressure checked more often if it's high, or if you're over 40, African American, or have excess body weight.

Why it matters: High blood pressure increases your risk for a heart attack, stroke, heart failure, kidney disease, and arrhythmias. But it doesn't usually cause symptoms. Only a blood pressure test can tell you whether your blood pressure is high.

How to help protect your heart: High blood pressure can be managed with lifestyle changes and medications. Eat a heart-healthy diet by limiting your salt and alcohol intake, be active for at least 150 minutes per week, and find ways to keep your stress levels low. If lifestyle changes don’t bring your pressure down, your doctor may prescribe blood pressure-lowering drugs that can help the body get rid of salt and water, or impact other causes of high blood pressure.

A cholesterol blood test

A cholesterol test measures LDL (bad) cholesterol, HDL (good) cholesterol, and triglycerides (a type of blood fat).

When you need it: Every four to six years beginning at age 20. Adults over 40 and those with heart disease or other risk factors may need to have their cholesterol checked more often. At that age, if a person’s blood cholesterol needs to be lowered, a coronary calcium score from a CT scan of the heart could be extremely helpful in helping doctors determine what treatment should be taken.

Why it matters: Cholesterol is a waxy substance found in the blood. High levels lead to blockages in the arteries and increase the risk for a heart attack and stroke. Like high blood pressure, high cholesterol doesn't usually cause symptoms. So getting tested is the best way to learn about your levels and how your body responds to them.

What's healthy: Ideal levels for LDL (bad cholesterol), HDL (good cholesterol), and triglycerides will depend on a number of risk factors — such as your age, sex, and family health history and if you smoke or have diabetes, or have a high calcium score — that your doctor will discuss with you.

How to help protect your heart: One of the best ways to lower your cholesterol is by paying attention to your diet. Limit your intake of unhealthy fats found in things like fatty red meat, full-fat dairy products, and fried foods. Eat more fruits, vegetables, whole grains, poultry, fish, and nuts, and cook with non-tropical oils like olive or vegetable oils.

Get at least 150 minutes of exercise per week, and take steps to reach and maintain healthy body weight, too. Losing as little as 5% of excess body fat can bring your cholesterol down. If lifestyle changes aren't enough, your doctor may also prescribe a cholesterol-lowering drug like a statin.

Blood glucose tests

There are three tests that can check the level of glucose, or sugar, in your blood, and your doctor will determine which of these are right for you.

When you need it: Every three years beginning at age 45. Adults under 45 who have excess body weight should also be screened if they have high blood pressure; high cholesterol; diabetes; are of African, Asian, Hispanic, Native American, or Pacific Islander descent; have a history of gestational diabetes; or have delivered a baby over 9 pounds.

Why it matters: Untreated high blood sugar can lead to diabetes, which can significantly raise your risk for heart disease and stroke.

How to help protect your heart: Many of the same strategies that support healthy blood pressure and cholesterol can also keep blood sugar in check. Eat a heart-healthy diet and limit your intake of added sugar, exercise regularly, and work toward achieving a healthy weight. If you smoke, take steps to quit. If you're having trouble controlling your blood sugar through diet and exercise alone, medications may help.

Body mass index (BMI)

Body mass index, or BMI, measures how much body fat a person has. It can be used to indicate whether a person is at an unhealthy weight. Your healthcare provider can quickly and easily calculate your BMI using your height and waist circumference or weight.

When you need it: BMI is typically calculated at routine doctor visits.

Why it matters: Excess body fat, particularly around the waist, can raise blood pressure and cholesterol. It also forces your heart to work harder. These things can increase the risk for heart disease, stroke, congestive heart failure, and atrial fibrillation.

What's healthy: A BMI between 18.5 and 24.9 is considered a healthy weight. Try our BMI calculator here.

How to help protect your heart: You can work toward reaching or maintaining a healthy weight by eating a healthy diet, controlling your caloric intake, and being physically active. Keep in mind that losing just a small amount of excess body fat can have a big impact on your health. Reducing your total weight by just 3% to 5% (if you need to lose weight) can help improve your blood sugar and triglyceride levels. 

Heart CT scan

A heart or cardiac CT scan, also called a calcium scoring test, uses a CT scanner to take images of your heart. These images can show whether you have a buildup of calcium in your arteries. The test takes only a few minutes.

When you need it: Your doctor may recommend a calcium scoring test if you're a man over 40 or a woman over 50 with certain heart disease risk factors like high blood pressure, high cholesterol, diabetes, family history, or smoking.

Why it matters: Calcium deposits can clog your arteries and increase your risk for heart attack or heart disease. Spotting the deposits sooner allows you and your doctor to decide on lifestyle steps and medications to manage your risk.

What's healthy: A normal or negative calcium score is 0. It means you don't have calcium buildup in your arteries.

How to help protect your heart: Good habits like eating a wholesome diet, exercising, and not smoking are the foundations of heart-healthy living. Depending on your individual risk factors, your doctor may recommend medications to control high blood pressure, high cholesterol, or other conditions. You may also need more frequent tests and exams to keep a close eye on your heart health.

When to see a cardiologist

Staying on top of your heart health starts with your primary care provider. If your recommended screenings reveal something serious or show that you're at high risk for heart disease, make an appointment at the Temple Heart & Vascular Institute. Our expert cardiologists can help you manage your condition and protect the health of your heart.

Helpful Resources

Looking for more information?

Daniel Edmundowicz, MS, MD, FACP, FACC

Dr. Edmundowicz is the Medical Director of the Temple Heart and Vascular Institute and has a special interest in cardiovascular disease prevention. He is national authority on the applications of atherosclerosis imaging to cardiovascular disease prevention and risk factor modification. He has lectured widely and published more than 80 peer-reviewed articles. He leads public health and epidemiologic studies and participates in multi-center clinical trials. Dr. Edmundowicz is a Fellow of the American College of Cardiology and past president of the ACC’s Pennsylvania Chapter. He is also a member of the American Heart Association and National Lipid Association.

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