CheckUps: More to Gain than to Fear

By Sharonne Hayes, M.D.

Although many patients still expect one, there’s really no good evidence that the old-fashioned annual checkup prevents or detects heart disease or other medical conditions in the average healthy adult who’s feeling well. But if you think this means you have license to put off your heart health checkup, think again.
           
In place of the unfocused head-to-toe physicals of the past, experts now recommend individualized “periodic health exams” or “preventive medical exams” targeted and scheduled to optimally prevent and detect diseases based on your personal health risks. What your checkup includes and how often you get one is based on your age, gender, personal and family medical histories, and overall disease risk. For example, if you are a 30-year-old nondiabetic, nonsmoker with normal cholesterol and blood pressure, you’ll need less frequent heart-risk checkups than a 55-year-old sedentary smoker with high blood pressure.
           
Your first preventive health exam should take place in your early 20s and should include a review of your personal medical history, lifestyle habits (diet, physical activity, smoking, alcohol use), and family history of heart disease, stroke, or diabetes. Your blood pressure and weight will be checked and, depending on your age and risks, your doctor may examine you for early signs of cardiovascular disease. Cholesterol and blood glucose levels also should be checked using blood tests, followed by a discussion with your doctor about what you can do with your lifestyle or medication to lower your heart disease risk. Finally, depending on your age and health risks, you and your doctor should decide when to schedule your next checkup.
           
In your 20s or 30s, the focus of your checkup is to get a baseline measure of your heart health, assess your risks for other diseases, and provide you with the information and tools to help you make healthy lifestyle choices. An average-risk person should have an appointment about every five years until age 40, then every other year until age 50, and annually thereafter. If you have uncontrolled risk factors, such as high blood pressure or cholesterol, diabetes, or smoking, or you have a strong family history of heart disease or stroke, you’ll benefit from more frequent visits.

Although your doctor won’t necessarily be looking in your ears at every routine visit, today’s targeted physicals are invaluable opportunities to connect with your doctor, evaluate your health risks, explore your concerns, and educate yourself about proactively improving your heart health at each stage of life. Take advantage of the opportunity.