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Screening Guide
Heart & Cardiovascular Screening
Heart screening looks at blood pressure, cholesterol, sugar and smoking to estimate your heart attack and stroke risk, so you can act early.
Overview
Heart attacks and strokes rarely come out of nowhere. They usually build up over years, driven by things like high blood pressure, high cholesterol, diabetes and smoking.
Most of these risk factors cause no symptoms. The World Health Organization (WHO) estimates that about 44% of adults with high blood pressure don't know they have it.
Heart screening is about finding these hidden risks early. Once you know your numbers, you and your doctor can work out your overall risk and how to bring it down.
Who may want to understand this screening
High blood pressure is the most important thing to check. The US Preventive Services Task Force (USPSTF) recommends blood pressure screening for all adults aged 18 and above. It suggests a yearly check from age 40, or if you are at higher risk, and every 3 to 5 years for adults aged 18 to 39 with normal readings and no extra risk.
WHO has cardiovascular risk charts for adults aged 40 to 80 without known heart disease. They combine your age, sex, smoking, blood pressure, diabetes and cholesterol to estimate your 10-year chance of a heart attack or stroke. Your doctor can use this kind of tool to guide advice.
You may need closer checks if you smoke, are overweight, are inactive, have diabetes or kidney disease, or have close family with early heart disease.
If you have symptoms, please don't wait for screening. Get help straight away for chest pain or tightness, pain spreading to the arm, jaw or back, sudden breathlessness, or sudden weakness of the face, arm or leg.
What screening may involve
The core checks are simple. We measure your blood pressure, weight and BMI, and take a blood sample for a lipid profile (cholesterol) and blood sugar such as HbA1c. We'll also ask about smoking, activity, diet and family history.
Blood pressure is measured after you have rested quietly for a few minutes. One high reading isn't enough for a diagnosis. WHO defines high blood pressure as 140/90 mmHg or above on two different days, and home readings can help confirm it.
Other tests, such as an ECG (heart tracing) or echocardiogram (heart ultrasound), may be suggested if you have symptoms, an abnormal finding or a specific concern. Your doctor tailors tests to you.
What screening can — and cannot — tell you
Screening can show whether your blood pressure, cholesterol or sugar are raised, and give an estimate of your overall risk. That estimate helps decide whether lifestyle changes alone are enough or whether treatment should be discussed.
It cannot predict exactly what will happen to you. A low-risk result is reassuring but not a guarantee, and it doesn't replace seeing a doctor if symptoms appear.
More tests are not always better. The USPSTF recommends against routine resting or exercise ECG screening in adults at low risk who have no symptoms, as it can lead to false alarms and unnecessary further tests. It also found not enough evidence to add hs-CRP to routine risk assessment. Homocysteine is not part of the standard risk charts either.
If anything is abnormal, your doctor will explain what it means and plan sensible follow-up.
Practical considerations
Wear a top with sleeves that roll up easily. Avoid smoking, caffeine and exercise just before your blood pressure check, and sit quietly for a few minutes first.
Ask the clinic whether your blood tests need fasting. Bring a list of your medicines, any home blood pressure readings and previous results.
If your blood pressure is high, you may be asked to check it at home over several days. Your doctor will review your results with you and agree when to check again.
Sources
1. Hypertension (fact sheet) — World Health Organization, 2025
2. World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions (WHO CVD Risk Chart Working Group, Lancet Global Health) — World Health Organization, 2019
3. Hypertension in Adults: Screening (Final Recommendation Statement) — US Preventive Services Task Force, 2021
4. Cardiovascular Disease Risk: Screening With Electrocardiography (Final Recommendation Statement) — US Preventive Services Task Force, 2018
5. Cardiovascular Disease: Risk Assessment With Nontraditional Risk Factors (Final Recommendation Statement) — US Preventive Services Task Force, 2018
Common questions
How often should I check my blood pressure?
Yearly if you are 40 or older or at higher risk. The USPSTF suggests every 3 to 5 years for adults aged 18 to 39 with normal readings and no extra risk.
Should everyone have an ECG?
No. The USPSTF recommends against routine ECG screening in low-risk adults without symptoms, but an ECG is useful if you have symptoms or specific concerns.
What blood pressure is considered high?
WHO defines high blood pressure as 140/90 mmHg or above, measured on two different days.
Are hs-CRP or homocysteine tests needed for screening?
Usually not. The USPSTF found insufficient evidence to add hs-CRP to routine risk assessment, and homocysteine is not part of standard risk charts.
I feel healthy. Why check my heart?
High blood pressure and high cholesterol usually cause no symptoms. Screening is the only way to find them before they cause harm.