Screening Strategies for Cardiovascular Disease in Asymptomatic Adults

Cardiovascular disease can remain hidden for a long time before it causes any noticeable symptoms. Screening can reveal these hidden health problems so that you can get the care that you need as quickly as possible. How do we decide who should be screened and how often?

Cardiovascular Disease in Asymptomatic Adults

Who is at Risk of Heart Disease?

Heart disease can affect anyone, including both men and women, older and younger people, and even professional athletes. However, we do know that some people are more likely to be affected than others. Anyone who is over the age of 30 can benefit from cardiac screening, but it is most important if you are at higher risk. You may need more frequent or extensive screening if you:

  • Are over the age of 40, as heart disease is more common as we grow older
  • Have a family history of heart disease, especially if your father or brother was affected before the age or 55 or your mother or sister was affected before the age of 65
  • Have a close relative who has been diagnosed with a hereditary heart condition such as a lipid disorder or hypertrophic cardiomyopathy
  • Are overweight or obese
  • Smoke or drink a lot of alcohol
  • Lead a sedentary lifestyle or a very active one that puts stress on your heart

How Do We Screen for Cardiovascular Disease?

Cardiac screening can involve different tests depending on your needs. For example, if you are a fit young adult in your 20s who is planning on running a marathon you might need sports screening including a treadmill ECG. However, this test isn’t usually needed for most routine screening in asymptomatic adults.

The most common screening strategy for lower risk adults involves:

  • Asking about your health, lifestyle and family medical history
  • Physical examination including measuring your weight and a blood pressure check
  • Blood tests to measure cholesterol, lips, glucose, C-reactive protein etc.
  • Feeding this information into a risk factor calculator such as QRISK to provide a simple score of your heart risk

The result of this screening will be a percentage that tells you the chances of developing cardiovascular disease in the next ten years.

If you are in a higher risk group, for example due to your family history, then additional tests such as an ECG may be recommended even if you are asymptomatic.

How Often Should You Be Screened?

All adults over 40 should consider having heart screening. Once you know your risk score, it can tell you how often you should come back to be checked again. As a general guide:

  • A low risk score of less than 10% means that you should come back in 5 years
  • A moderate risk score of 10-20% means that you should be screened every year
  • A high-risk score over 20% means that you will probably need closer monitoring

If you have a moderate or high risk of heart disease, then your doctor will also recommend some lifestyle changes and treatments to reduce the risk. You may also need some additional tests, such as an ECG or echocardiogram to check on your heart.