The Heart Tests to Get

A lot of flashy cardiovascular tests have been in the news lately, including computerized X-ray “snapshots” that can give a remarkably detailed picture of your heart and its vessels.

But, for most people, the old-fashioned combo will yield enough information to get an accurate sense of the odds of developing heart disease within the next decade.

The Basics

Your physician will ask you about your family history. If your father developed heart disease before age 55, or your mother before age 65, it approximately doubles your own risk. If your brother or sister has been diagnosed with premature heart disease, you're twice as likely to develop it. Your doctor will watch your blood pressure and your blood sugar too, because diabetes roughly doubles the odds of heart disease.

Periodically, you'll need a fasting lipid blood test to gauge levels of three blood fats:

• LDL (low-density lipoprotein), aka bad cholesterol, builds up in the inner walls of blood vessels and is one of the ingredients in artery-narrowing plaque
• HDL (high-density lipoprotein) clears excess cholesterol from the arteries, dumping it into the liver for disposal
• Triglycerides, a type of fat, provide your body with energy but also cause problems, possibly by helping to thicken artery walls.

Each measurement is important, but so are certain combinations. Metabolic syndrome, a condition in which the body doesn't handle insulin properly, doubles your odds of a heart attack.

Diagnosis is based on the presence of three of the following factors:

• abdominal obesity
• high triglycerides
• low HDLs
• high blood pressure
• elevated blood sugar.

Extras That May Help

You may feel fine, yet worry about your risk factors, like elevated cholesterol or a family history. Many experts say that these promising tests can sometimes give important information:

• High-sensitivity C-reactive protein test: CRP is a protein manufactured by the liver in response to inflammation. The evidence is building that inflammation may be as much of a villain in heart disease as high cholesterol, so this simple and relatively inexpensive blood test may soon become a standard part of risk evaluation. Results above 3 mg/dl are considered high risk, though other illnesses or simply being overweight can also raise levels.
• Ankle-brachial index: For this test, a doctor takes your blood pressure at your arm and your ankle. If the pressure at your ankle is appreciably lower, it suggests that arteries may be clogged. The results appear to be particularly useful for women, moving a substantial percentage from a low-risk category to a higher-risk one. Not all doctors have the necessary equipment.