Heart Disease Risk Factors and Screening

Heart disease is the leading cause of death in the United States, affecting men, women, and people of most racial and ethnic groups. One person dies every 34 seconds from cardiovascular disease, making early detection and prevention critically important.

Heart disease typically develops over many years as plaque builds up in the arteries that supply blood to the heart. Several health conditions, lifestyle choices, and family history can increase risk for heart disease. High blood pressure, high blood cholesterol, and smoking are key risk factors, with about half of people in the United States (47%) having at least one of these three risk factors. Many people are unaware they have risk factors because heart disease can develop silently, which is why screening through lab testing is so valuable for early detection and prevention.

Lifestyle factors can significantly increase heart disease risk. Eating a diet high in saturated fats, trans fat, and cholesterol has been linked to heart disease and related conditions, such as atherosclerosis. Too much salt (sodium) in the diet can raise blood pressure. Physical inactivity, smoking, and excessive alcohol consumption also contribute to cardiovascular risk.

Some risk factors cannot be controlled, such as age or family history. Genetic factors likely play some role in high blood pressure, heart disease, and other related conditions. However, people with a family history of heart disease may also share common environments and other factors that may increase their risk. Medical conditions like diabetes, high blood pressure, and obesity can further compound cardiovascular risk when combined with lifestyle factors.

Lab testing for heart disease risk may be beneficial for adults who have multiple risk factors or concerning symptoms. During August 2021—August 2023, 36.4% of U.S. adults had no cardiovascular disease risk factors, 34.9% had one, and 28.7% had two or more. The percentage of adults with no risk factors decreased with age, and the percentage with multiple risk factors was higher among older adults.

Consider heart health screening if there's a family history of early heart disease, elevated blood pressure readings, concerns about cholesterol levels, diabetes or prediabetes, or a combination of lifestyle risk factors like smoking, sedentary lifestyle, or poor diet. Regular screening can help detect problems before symptoms develop and guide preventive measures to reduce cardiovascular risk over time.

While cholesterol and triglyceride levels can play a significant role in overall health, many other factors contribute to risk for cardiovascular disease. Healthcare providers take many factors about health and history into consideration when determining the next steps. Abnormal lipid panel results may suggest increased cardiovascular risk, but interpretation depends on individual circumstances and other risk factors.

For CRP testing, levels less than 1.0 mg/L are considered to denote low risk, 1.0 to 3.0 mg/L intermediate risk, and more than 3.0 mg/L high risk for cardiovascular events. Elevated A1c levels may indicate prediabetes or diabetes, both of which significantly increase heart disease risk. It's important to discuss all test results with a healthcare provider who can interpret them in the context of overall health and recommend appropriate next steps for risk reduction.

Heart-healthy lifestyle choices can significantly reduce cardiovascular disease risk. Regular physical activity, a balanced diet low in saturated fats and sodium, maintaining a healthy weight, not smoking, and limiting alcohol consumption all support cardiovascular health. Stress management techniques like meditation or regular exercise may also help reduce inflammation and support heart health.

Even small changes can make a meaningful difference in cardiovascular risk over time. Working with healthcare providers to develop a personalized plan that addresses individual risk factors through both lifestyle modifications and medical management when appropriate can help optimize heart health and reduce the likelihood of developing cardiovascular disease.