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Heart Disease


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What Health Screenings Do You Really Need If You Are Over Age 50?

8 key tests the experts recommend

Heart disease: blood pressure, cholesterol, blood sugar, weight

The tests: blood pressure and weight measurements, blood tests for cholesterol and sugar levels; ultrasound exam for abdominal aortic aneurysm.

The guidelines: The experts recommend getting your blood pressure checked at least every two years, your cholesterol checked regularly as determined by your doctor, and your blood sugar tested (a screen for diabetes) if you have high blood pressure or, for men, elevated cholesterol. People at heightened risk for dangerous abnormal enlargement of a large blood vessel in the abdomen that feeds blood to the entire body—men ages 65 to 75 who have ever smoked­ — should be checked for that with a one-time ultrasound.

What to consider: If there's a no-brainer when it comes to medical screenings, the basic cardiovascular health checks are it. High blood pressure, for example, is usually asymptomatic; the test for it is reliable, quick and harmless; and managing the condition with lifestyle changes and drugs can head off very serious consequences like stroke.

Abdominal aortic aneurysm is likewise a silent killer, treatable with surgery or stents, says Gary Balady, M.D., director of preventive cardiology at Boston Medical Center.

Doctors also should ask about smoking and physical inactivity, key risk factors, Balady adds.

On the other hand, the host of sophisticated cardiovascular screenings often promoted in the so-called executive physical may do more harm than good when used to screen people with no symptoms or marked risk factors. In these folks, for example, a cardiac stress test is more likely to yield a false positive — to suggest a problem where none exists — leading to more testing, potentially including invasive procedures, says Balady.

Next: Pap smear. »

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