February 1, 2013
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.
"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, except blood glucose measurements, which should begin at age 45.
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 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. 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.
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.
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.