If you’ve never received a heart screening before, you may have more questions than answers about the process, what to expect and when you should consider screening.
To help dispel some of the confusion around heart screenings—and in observance of American Heart Month—we spoke with University of Minnesota Heart Care Cardiologist Ashenafi Tamene, MD, whose clinical interests include cardiovascular prevention and coronary artery disease.
I have a family history of heart disease. When should I start screenings? How often should they take place?
There are different kinds of familial heart disease and it can be difficult to make general recommendations about screening. Because our advice depends on the specific type of heart disease identified by doctors, it is very important that patient discuss the details of his or her family history with their physicians. For example, screening recommendations for hypertrophic cardiomyopathy, a type of genetic heart disease that affects the heart muscle, differ from those with familial lipid abnormalities. Patients who have immediate family members with a diagnosis of hypertrophic cardiomyopathy should receive genetic testing as well as cardiac imaging. Patients with history of familial lipid abnormalities need to have their cholesterol levels checked and appropriate therapies instituted to avoid premature coronary artery disease.
How often should I be screened if I do have a history of heart disease?
The frequency of screening depends on the type of disease we find. Often, I see patients with a family history of premature coronary artery disease—and at least one a family member who has had a heart attack or a surgery to treat a blocked coronary artery at a young age. In these cases it may be important to check blood cholesterol levels for lipid abnormalities. Other tests may be needed depending on the patient’s age and other risk factors, including smoking, high blood pressure or diabetes. If the initial screening discovers health issues, you may need to schedule more frequent visits.
What if I have no pre-existing risk factors? Should I still be screened?
We recommend most patients begin screening for atherosclerotic disease risk factors when they are 20 years old. If we don’t find any issues during the initial screening, similar testing can be performed every four to six years.
What tests should I expect during a heart screening?
We typically check cholesterol levels and blood pressure, and measure body-mass index and waist circumference. We also look for certain medical issues or risk factors, such as hypertension, diabetes and smoking. Using patient’s demographic information (race, gender, age), blood pressure level and cholesterol values, we calculate a 10-year or lifetime risk for atherosclerotic disease. For some patients, this score can be a wake-up call to make life style changes; for others it is helpful for determining what additional testing or therapy is needed.
What steps should I take to monitor myself at home?
We don’t recommend any home monitoring if people are healthy. Behaviors that promote overall good health, including healthy eating and exercise, are important and pay long-term dividends for a person’s health. For patients with diseases including hypertension, diabetes or heart failure, home monitoring may mean checking blood pressure, checking blood sugar levels or measuring body weight on a regular basis to guide appropriate treatment.