Just because you turn 40 doesn’t mean heart disease is just around the corner. But hitting that milestone is a good opportunity to start thinking of health checks as more than just something you get when you feel unwell.
Blood pressure, cholesterol, blood sugar, smoking, excess weight and physical inactivity can all play a role on cardiovascular risk. Your doctor can even estimate your chances of developing cardiovascular disease within the next decade using these factors if you’re an adult aged 40 to 75 years. Along with the traditional suspects, there are a few less familiar tests that your doctor may consider if you have additional risk factors.
Here’s what they are and how they can help.
1. Fasting insulin: Could your body be working overtime?
You may be familiar with fasting blood sugar, but what about fasting insulin? A fasting insulin test measures the amount of insulin your body is producing after not eating.
High levels can indicate that your body may be developing resistance to insulin, which means its cells don’t respond to insulin as they should. It can become especially important if you’ve gained excess weight around your waist, have a family history of diabetes or have blood sugar results that are outside of the normal range.
The test isn’t necessarily part of the routine battery of heart tests everyone should get. If you think you may need it, ask your doctor.
2. hs-CRP: Checking in on inflammation
High sensitivity C-reactive protein, or hs-CRP, measures very low levels of CRP. CRP is a protein produced by the liver that’s linked to inflammation.
Doctors may use it as part of the overall picture when determining cardiovascular risk. But there’s a caveat: An infection, injury or other inflammatory process can also raise CRP levels. So if you have one elevated result, it doesn’t necessarily mean you’re at risk of heart disease. The USPSTF states that there is insufficient evidence to assess the balance of benefits and harms of screening for cardiovascular disease risk with hs-CRP in asymptomatic adults who have no history of cardiovascular disease. Therefore, they do not recommend routine use of hs-CRP for cardiovascular risk assessment in all healthy adults.
3. LDL particle testing
Standard cholesterol tests measure how much LDL cholesterol you have in your blood. But LDL particle testing drills down even further. It looks at how many particles you have that are carrying cholesterol and what type those particles are.
LDL particle testing may be able to provide additional insight when someone’s cholesterol numbers don’t quite add up. Your doctor may consider it if you have diabetes, metabolic issues or a strong family history of heart disease at an early age.
4. Urine albumin-to-creatinine ratio
While this isn’t technically a blood test, your doctor may order it along with the others. The urine albumin-to-creatinine ratio checks for small amounts of the protein albumin in your urine.
Why does that matter for your heart? Albumin in your urine can signal kidney issues, but it can also be linked to higher cardiovascular risk. Doctors may use it to help assess heart risk along with other factors if you have diabetes or high blood pressure.
5. NT-proBNP: What is it telling you about your heart?
NT-proBNP is a substance that can be found in higher levels when the heart is strained. Doctors may order the test when someone comes in with symptoms like unexplained shortness of breath, swelling or unusual fatigue, among others. Heart failure is one possibility they may be looking to rule out or confirm.
Unlike the other tests on this list, it isn’t something that every person needs because they turned 40. It very much depends on symptoms and medical history.
The tests you shouldn’t forget
These new-to-you tests don’t replace your standard blood pressure check. Measures like blood pressure, cholesterol, blood glucose or HbA1c levels, along with your weight and an assessment of your lifestyle, are important factors in determining your cardiovascular risk. Experts recommends regular blood-pressure screenings for adults. They even suggest that those aged 40 years and older get their pressure checked every year.
Rather than getting every test you can after you turn 40, focus on understanding your risk factors. Talk to your doctor about which tests make sense for you.
