It’s nearly impossible to know whether you have certain key risk factors for heart disease without screening for them. But which tests are right for you? Here’s a basic guide to a few common ones accompanied by guidelines from the Mayo Clinic as to who needs them and how often.
By Rashad J. Gober
How it’s measured: with a blood pressure cuff
Who needs it:
- all adults ages 18+ at least once every two years if healthy; more often if reading is 120/80 or higher
- those at a younger age if risk factors are present
High blood pressure (HBP), or hypertension, is an important risk factor for heart disease that not only has no symptoms, but is also impossible to detect without having it measured. It can reach dangerously high levels without any sort of warning – that’s why it’s often called the “silent killer.” “You can have damage occurring all over your body without any signs of it actually happening,” says Dr. Roger DeVersa, an internal medicine physician with Kindred Hospital Chattanooga and Erlanger Health System. “And if your blood vessels are exposed to high pressure over time, they’ll try to compensate by becoming thicker. This narrows them so less blood flows through.”
Blood pressure readings are made up of two numbers written as a ratio. According to the Mayo Clinic, an optimal reading is less than 120/80 milligrams of mercury. If either number is higher, that means it’s time to start creating an action plan with your doctor for how to lower it. “Once you have high blood pressure, that doesn’t mean you always have it or will always need to be on medication,” says Dr. DeVersa. “Many patients can rid their bodies of it through lifestyle changes, but it’s hard to do. You have to want to do something about it.”
How it’s measured: with a blood test
Who needs it: all adults ages 20+ once every five years if healthy; more often if high those at a younger age if risk factors are present
A cholesterol test, also known as a lipid panel, is a heart health screening that measures the different kinds of fats, or lipids, in your blood. Specifically, it measures total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides.
Dr. Jennifer Mirza with Cardiology Services of Cleveland explains that you want your total cholesterol and LDL cholesterol to be low (ideally, below 200 mg/dL and 100 mg/dL, respectively) and your HDL cholesterol to be high (ideally, greater than 40 mg/dL). That’s because too much LDL cholesterol, also known as the “bad” cholesterol, can lead to plaque build-up in your arteries. “These lipoproteins are like bowling balls going down a hallway,” Dr. Mirza explains. “They are heavy and dense and can cause damage to blood vessels and arteries.” In contrast, you want your HDL cholesterol to be high because it helps carry the LDL cholesterol away from your blood vessels to the liver.
Fasting Blood Sugar
How it’s measured: with a fasting blood test (no food or drink 12 hours prior)
Who needs it: adults ages 45+ once every three years if healthy; more often if high anyone with a body mass index higher than 25, regardless of age those at a younger age if risk factors are present
Checking your blood sugar levels might not seem like the most obvious screening test for heart health – most people associate it solely with diabetes. But research shows that high blood sugar also plays a significant role in the development of heart disease. “Having prediabetes or diabetes affects everything in the body, including the coronary arteries,” says Dr. Mirza. “When there is inflammation, that’s when blockages can start happening.” According to the American Heart Association, a blood glucose range under 100 mg/dL is considered normal. A reading of 100-125 mg/dL is prediabetic range, and a reading of greater than mg/dL is indicative of type 2 diabetes.
How it’s measured: with a blood test
Who needs it: those at known risk of heart disease those who fall into an intermediate heart attack risk category
The c-reactive protein test looks to see whether you have higher than average amounts of c-reactive protein in your blood. If you do, that indicates there is swelling somewhere in your body. “The c-reactive protein test shows whether or not your body has a small amount of chronic inflammation,” says Dr. Charles Campbell, chief of cardiology with UT Erlanger Cardiology. “That’s related to risk for heart disease, because arteries that are inflamed are more at risk.” According to the American Heart Association, a c-reactive protein test isn’t recommended for the general population to screen for heart disease risk. Rather, doctors use it to see whether people who seem to have an intermediate risk of heart disease may actually be in a high-risk category. “I only use it for people that I’m worried about,” says Dr. Campbell.
Coronary Calcium Scan
How it’s measured: with a CT scan
Who needs it: those who fall into an intermediate heart attack risk category those who have symptoms of heart disease
A coronary calcium scan is an X-ray that looks for calcifications, or specks of calcium, in the plaque found in the arteries. It’s an important heart screening test because the higher the levels of coronary calcium, the further the extent of the damage to your arteries. However, this kind of screening isn’t for everybody. The American Heart Association does not recommend the screening for those who don’t have symptoms of heart disease or elevated risk factors. “I use it for very similar reasons that I use c-reactive protein testing,” says Dr. Campbell. “It’s best for separating intermediate risk patients from high risk patients.”
EKG/Exercise EKG (Stress Testing)
How it’s measured: electrodes attached to your chest, arms, and legs
Who needs it: those suspected of having heart disease based on symptoms or risk factors
An electrocardiogram (abbreviated ECG or EKG) is a test that examines the electrical activity of your heart. It is a great tool for detecting abnormalities in the heart rhythm and structure. However, not everyone will need one. “An EKG is most helpful for patients whose symptoms may be due to heart disease – chest discomfort, shortness of breath, palpitations,” says Dr. Vinay Madan, a cardiologist with the Chattanooga Heart Institute at CHI Memorial. “It can also be used to screen for heart disease in patients without symptoms but with certain conditions known to increase risk.”
During the test, electrodes attached to your chest monitor the strength and timing of the electrical signals as they pass through your heart. This provides information about how fast the heart is beating as well as the presence of any rhythm irregularities.
An exercise EKG is very similar, except that the monitoring occurs while you walk on a treadmill at progressively faster speeds and steeper inclines. “A resting EKG is more of a snapshot of your heart at a moment in time, whereas an exercise EKG shows how your heart responds to stress. It can suggest the presence of blockages in blood vessels that supply the heart,” says Dr. Madan.
Learn More! If you believe that you are at risk for heart disease, see a healthcare provider as soon as possible for testing. However, it’s important to understand that while these tests play an important role when it comes to measuring the state of your health, they are no replacement for living a heart-healthy lifestyle. The American Heart Association website heart.org has some excellent suggestions on how to keep your heart healthy by eating right and exercising consistently. Visit online today!