What Doctors Want You to Know About Heart Health Screening Tests
Heart disease is the leading cause of death in the U.S., accounting for one in five deaths among American adults in 2020. Heart disease encompasses a wide range of conditions from congenital heart defects to conditions that can develop over time as a person gets older.
Risk factors for heart disease, like high blood pressure, high cholesterol and high blood sugar, are often symptomless. Scheduling an annual physical is important to screen for potential risks for heart disease and to determine if additional tests are needed. Heart disease is easier to treat when detected early.
What are heart screenings and what do they mean?
As part of a routine checkup or annual physical, physicians may conduct screenings to help identify one’s risk for developing heart disease and discuss steps one can take to lower their risk. For example, someone may find they need to change their diet or add an exercise regimen. Some screening results will indicate the need for additional testing.
Heart health screenings are usually part of a standard adult annual physical and include:
- Discussion of health habits, such as diet, exercise and smoking: Doctors will discuss healthy – or unhealthy – habits with patients to determine what strategies are working and produce recommendations to improve heart health.
- Body mass index: Very simply, this is a ratio of one’s weight in relation to their height. A BMI score of 25 or more indicates that a person is overweight, which can increase risk for obesity, heart disease, and other chronic diseases.
- Blood pressure: Blood pressure measures the force of blood pushing through blood vessels. When blood pressure is too high, it makes the heart work harder to pump blood and increases the risk for heart attack and stroke. High blood pressure can be managed with diet, exercise and medication.
- Cholesterol: A fasting lipid profile test measures the amount of cholesterol, a waxy substance, in the blood. There are good and bad types of cholesterol, but a high overall cholesterol level contributes to heart disease. High cholesterol can be managed with lifestyle changes and medication.
- Blood sugar: High blood glucose (or blood sugar) levels can indicate diabetes or prediabetes. Diabetes damages the heart and blood vessels which increases the risk of developing heart disease.
What are heart tests and when are they needed?
When an elevated risk or concerning result is found on a screening exam, or if an individual is exhibiting symptoms of a potential problem, physicians may recommend additional tests.
The most common initial tests that a doctor may order include:
- Electrocardiography (ECG or EKG): This test is quick and painless, using electrode patches placed on the body to measure the electrical activity of the heart. It can indicate a potential heart rhythm problem and sometimes can indicate whether a heart attack has occurred.
- Exercise stress test: This test also uses electrode patches placed on the body to measure heart activity during exercise. It monitors the heart’s blood supply and rhythm and can identify the cause of chest pain or other symptoms.
- Echocardiography: This test uses sound waves to visually show how the blood is flowing through the heart. It helps doctors assess how the heart and heart valves are functioning.
Typically, the three tests above are used first, to identify whether further testing is needed.
Checking on one’s heart health is an important part of one’s overall health journey. Following a healthy diet, leading a healthy lifestyle, limiting alcohol consumption, not smoking, maintaining a healthy weight and seeing a doctor for an annual physical are good strategies.
For new or changing symptoms, talk to a health care provider immediately about concerns over heart health. Always seek emergency care by calling 911 if chest pain, shortness of breath or fainting occur.
James D. Grant, M.D., is senior vice president and chief medical officer at Blue Cross Blue Shield of Michigan. For more health news and information, visit MIBluesPerspectives.com.
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