HOW HEALTHY IS YOUR HEART, REALLY?

SO MANY TESTS-FROM BP TO ECGS-CLAIM THEY CAN GRADE YOUR HEART'S PERFORMANCE. WHICH IS GREAT, BUT THAT'S A LOT OF TESTING. USE THIS GUIDE TO ZERO IN ON WHICH YOU NEED-AND WHICH TO SKIP-TO SAVE TIME, STRESS AND MAYBE EVEN YOUR HEART ITSELF

- DR. CHRISTOPHER KELLY

THE BASICS

EVEN IF YOU THINK you're healthy, the following tests tell you how proactive you need to be about changing your lifestyle or taking medications.

CHOLESTEROL PANEL

This blood test measures total cholesterol, triglycerides, LDL ("bad" cholesterol), and HDL ("good" cholesterol). Most doctors focus on LDL, which has been most closely tied to the risk of heart attack and stroke. Your specific LDL goal depends on how many risk factors you have for heart disease, but a level greater than 130 mg/dL is considered elevated. Start this check at age 20 at the latest, and get it every three years, at least.

BLOOD-PRESSURE CHECK

High pressure in your arteries wears them down and increases the build-up of heart-attack-causing plaque. Get your BP checked each year at the doctor's office, or just grab your own cuff (ideally from the list of accurate ones at validatebp.org) and aim for less than 120/80.

A1C TEST

Diabetes greatly increases the rate of plaque build-up in your arteries. The easiest way to screen for diabetes is the hemoglobin A1C test, which reflects your average blood sugar over several months. It can be done with a cholesterol panel. Normal is below 5.7; prediabetes is between 5.7 and 6.4. Above that indicates diabetes.

THE ASCVD RISK ESTIMATOR PLUS TEST

This one you do online. If you're 40 or older, plug your blood pressure and cholesterol into the calculator at tools.acc.org/ASCVDThis estimates your Risk-Estimator-Plus chances of a heart attack or stroke in the next ten years and determines how aggressive you need to be about getting your numbers down. For example, lower-risk people might try lifestyle changes, while people at higher risk may try medications. If you're in the middle, the tests in the next section help clarify what you should do.