Heart health: 10 cardiologist-recommended medical tests to detect heart disease risk (and when to start testing)

Not pulling the rom-com-inspired strings here, but it should not even be up for debate why paying attention to heart health is so important. This one organ of the human body is glorified for all things emotional (isn’t it romantic!), and not nearly enough for all the functional purposes it serves. The heart is responsible for pumping blood, oxygen, and nutrients to every part of the body, and maintaining a healthy heart is essential for long life, high energy levels, and a better quality of life.

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So, doing our bit to keep the heart healthy isn’t only necessary; it’s imperative.

And keeping your heart healthy starts with knowing your risks.

What’s the one thing that helps you take measures and precautions to navigate through the various risks of cardiovascular disease? Screening. Screening. Screening.

Cardiologists around the world agree: early and regular testing can spot heart disease before it becomes serious. From everyday checks like blood pressure and cholesterol to advanced scans like coronary calcium scoring, the right tests reveal much about your heart’s condition.

Whether you're in your 20s or approaching your golden years, there's a smart schedule for screening. Knowing what these tests reveal, when to begin them, and how often to repeat them empowers you to act and protect your heart proactively.

Ready to sign yourself up for better care for your heart? Sign yourself up for these tests below.

A blood pressure test is a quick, noninvasive test that is a routine part of health checkups to monitor heart health and detect high blood pressure.

What it measures: It measures the force of blood against your artery walls. An inflatable cuff on the arm tightens to temporarily stop blood flow, then slowly releases air, allowing a healthcare professional or device to detect the point when blood flow resumes (systolic) and when it returns to smooth flow (diastolic). High levels can lead to heart attacks and strokes, often with no symptoms.

When to start: Begin in your 20s; most adults should have it checked during routine visits.

Frequency: At least once every two years if normal; annually or more often if elevated or risk factors are present.

A lipid profile test is a blood test that measures different types of fats, or lipids, in your blood. This comprehensive test helps assess your risk of cardiovascular diseases, such as heart attacks and strokes, by identifying high levels of lipids that can lead to plaque buildup in arteries.

What it measures: It measures levels of total cholesterol, LDL ("bad"), HDL ("good"), and triglycerides, key indicators of plaque buildup.

When to start: Around age 20. Earlier, if there are risk factors.

Frequency: Every 4-6 years if results are normal; more often past age 45 or with risk factors. Men 45-65 and women 55-65 may need testing every 1-2 years.

A blood glucose test measures the amount of sugar (glucose) in your blood, which is your body's main source of energy from food. These tests are used to screen for conditions like prediabetes and diabetes, which can occur if your body doesn't produce or use insulin properly.

What it measures: Your blood sugar level, a warning sign of diabetes, which significantly increases heart disease risk.

When to start: Around age 45, or earlier if overweight, hypertensive, or with a family history.

Frequency: Roughly every three years.

Body Mass Index (BMI) is a measure that uses a person's height and weight to estimate body fat and assess health risks associated with being overweight or obese. Meanwhile, waist circumference is a measurement of the distance around your waist, which indicates the amount of abdominal fat, and is also used as an indicator of health risk, particularly when combined with BMI.

What it measures: Body fat and fat distribution, especially around organs, linked to higher heart risk.

When to start: Typically measured at every routine visit from early adulthood.

Frequency: Regularly, as part of health checkups.

The Framingham Risk Score is a sex-specific algorithm used to estimate the 10-year cardiovascular risk of an individual. The Framingham Risk Score was first developed based on data obtained from the Framingham Heart Study to estimate the 10-year risk of developing coronary heart disease.

What it does: Combines multiple risk factors into a 10-year cardiovascular risk estimate, guiding preventive decisions.

When to start: Risk calculators start being useful in the 20s-30s; more comprehensive tools like PREVENT™ for ages 30-79.

Frequency: Every 4-6 years, or sooner with changing risk factors.

A coronary artery calcium (CAC) score test is a non-invasive test that helps doctors assess an individual's cardiovascular risk, using a CT scan to measure the amount of calcified plaque in the coronary arteries, providing a number that indicates the risk of coronary artery disease (CAD) and future heart events.

What it measures: Amount of calcium in the coronary arteries, an early indicator of atherosclerosis. A higher score suggests more significant plaque buildup and a higher risk of a heart attack.

When to start: Men 40+, women 50+ with risk factors; AHA suggests CAC, especially in 40s-50s.

Frequency: Rarely repeated, used selectively when risk assessment is uncertain.

The high-sensitivity C-reactive protein (hs-CRP) test measures systemic inflammation, while the Lipoprotein(a) test measures a specific type of cholesterol particle linked to atherosclerosis. Together, these blood tests assess your risk for cardiovascular disease (CVD), with elevated levels of both indicators suggesting increased risk.

What they measure: hs-CRP shows inflammation; lipoprotein(a) reveals genetic cholesterol risk missed by standard tests.

When to start: In 30s-40s, especially for those with a family history or unclear risk.

Frequency: When assessing risk, typically assessed once or repeated to monitor changes.

An Electrocardiogram (ECG or EKG) is a painless, non-invasive diagnostic test that records the electrical activity of the heart over time. By placing electrodes on the skin, the ECG generates wavy lines on a graph, allowing healthcare providers to detect heart abnormalities, monitor heart conditions, and assess the heart's rate, rhythm, and overall health.

What it measures: Heart’s electrical activity, used to detect arrhythmias, heart attacks, and other issues. This test helps diagnose various cardiac conditions, such as irregular heartbeats (arrhythmias), heart attacks, and blocked arteries.

When to start: Often ordered if symptoms or upon exceeding age 40-50 or having risk factors.

Frequency: As determined by your doctor, routine use may not be needed unless risk or symptoms arise.

A neck circumference test is simply the act of measuring the circumference of a person's neck with a flexible tape measure, positioned just below the Adam's apple. This simple, inexpensive, and quick measurement serves as a screening tool for overweight and obesity, as a larger neck circumference often indicates increased fat in the upper body.

What it measures: Fat deposit around the neck, emerging as an easy predictor of cardiometabolic risk. It also acts as a marker for central obesity and can predict health risks like cardiovascular disease and metabolic issues, such as diabetes and high blood pressure.

When to start: Mid-adulthood during routine checkups.

Frequency: Can be measured annually with other vital signs.

Advanced inflammation and atherosclerosis markers, like Carotid Intima-Media Thickness (CIMT) and Urine Albumin-Creatinine Ratio (UACR), are diagnostic tools that help assess the risk of cardiovascular diseases such as heart attack and stroke.

What they measure: Tests such as carotid intima-media thickness (CIMT), urine albumin-creatinine ratio (UACR) indicate early artery or kidney damage. These tests can detect early vascular damage before symptoms appear, offering more insight into cardiovascular risk than traditional factors alone.

When to start: From 30s-40s if extra risk factors or hypertension.

Frequency: As part of specialized risk screening, the interval depends on findings.

Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice, diagnosis, or treatment. Always consult a licensed healthcare provider for personalized guidance regarding heart health or medical conditions. Do not delay seeking professional care because of something you read here. If you're experiencing a medical emergency, call your local emergency services immediately.

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This article is for informational purposes only and should not be considered a substitute for professional diagnosis or treatment. If you have any health concerns, seek guidance from a health professional.