Heart, diabetes, bone and aorta screening: guidelines compared

For blood pressure, diabetes, cholesterol, osteoporosis and abdominal aortic aneurysm (AAA), the USPSTF is not the only voice. The American Diabetes Association (ADA), the American College of Cardiology and American Heart Association (ACC/AHA), the Bone Health and Osteoporosis Foundation (BHOF) and the Society for Vascular Surgery (SVS) publish their own advice. Here they are side by side for adults at average risk, each with its date.

Average risk only. Every row is for adults without symptoms and without the condition already. If you have a strong family history or a known condition, see family history: when screening starts earlier, and talk to your doctor.

Side by side

Average-risk screening for blood pressure, diabetes, cholesterol, osteoporosis and AAA: USPSTF compared with specialty societies
Screening	USPSTF	Specialty society
Blood pressure	All adults 18+ (A): every year from 40 or at higher risk; every 3 to 5 years at 18 to 39 with a normal reading and no added risk; confirm high office readings outside the clinic before treatment (USPSTF, 2021)	ACC/AHA: from 20, measure the usual heart risk factors at least every 4 to 6 years; at 40 to 75, assess them routinely and calculate 10-year heart risk (ACC/AHA, 2019). A 2025 AHA/ACC high blood pressure guideline replaced the 2017 one; its full text was not open to us, so we do not quote its details (AHA/ACC, 2025)
Diabetes	Adults 35 to 70 with overweight or obesity (B); every 3 years may be reasonable after a normal result (USPSTF, 2021)	ADA: everyone from 35, repeated at least every 3 years if normal; earlier at any age with a BMI of 25 or more (23 or more in people of Asian ancestry) plus one or more risk factors; yearly with prediabetes; every 1 to 3 years after gestational diabetes (ADA, 2026)
Cholesterol	No separate cholesterol screening statement for adults. Statins at 40 to 75 with 1 or more risk factors and a 10-year risk of 10% or more (B), selectively at 7.5% to under 10% (C); 76 and older: evidence insufficient (I). The risk estimate uses cholesterol levels (USPSTF, 2022)	AHA/ACC: screening can use a fasting or nonfasting lipid test; at 20 to 39, the focus is lifetime risk and lifestyle (AHA/ACC, 2018). Risk factors at least every 4 to 6 years from 20; 10-year risk at 40 to 75 (ACC/AHA, 2019)
Osteoporosis	Women 65+ (B); postmenopausal women under 65 at higher fracture risk (B); men: evidence insufficient (I) (USPSTF, 2025)	BHOF: bone density test for women 65+ and men 70+; postmenopausal women and men 50 to 69 based on risk profile; anyone 50+ with a fracture as an adult (BHOF, 2022)
Abdominal aortic aneurysm	One-time ultrasound for men 65 to 75 who ever smoked (B); selectively for men 65 to 75 who never smoked (C); not for women who never smoked and have no family history (D); women 65 to 75 who ever smoked or have a family history: evidence insufficient (I) (USPSTF, 2019)	SVS: its 2018 guideline covers screening, but the full text needs a subscription, so we do not restate it (SVS, 2018). Medicare covers one ultrasound with a referral for a family history of AAA, or a man 65 to 75 who smoked at least 100 cigarettes (Medicare.gov)

Where they differ most

Diabetes: weight or age. The USPSTF screens adults 35 to 70 who have overweight or obesity. The ADA tests everyone from 35, whatever their weight, and starts earlier for people with overweight plus a risk factor. (USPSTF, 2021) (ADA, 2026)
Cholesterol: a test or a risk estimate. The USPSTF has no stand-alone adult cholesterol screening statement; it starts from a 10-year risk estimate at 40 to 75. The ACC/AHA check risk factors from 20. (USPSTF, 2022) (ACC/AHA, 2019) More: cholesterol test by age.
Bone density: men. The USPSTF found the evidence for men insufficient; the BHOF recommends testing men from 70, and from 50 with risk factors. (USPSTF, 2025) (BHOF, 2022)
Blood pressure: when to check. The USPSTF sets intervals by age and risk; the ACC/AHA 2019 guideline folds blood pressure into a heart risk check every 4 to 6 years from 20. (USPSTF, 2021) (ACC/AHA, 2019)
AAA: women and family history. The USPSTF makes no call for women who smoked or have a family history; Medicare still covers a one-time ultrasound for anyone with a family history and a referral. (USPSTF, 2019) (Medicare.gov)

This site's screening planner and age pages follow the USPSTF only (Method), because its A and B grades are the ones tied to no-cost coverage under the Affordable Care Act: USPSTF grades explained. For cancer screening, see cancer screening guidelines compared.

Questions people ask

Should diabetes screening start at 35 for everyone?

The ADA says yes: testing for everyone from 35, repeated at least every 3 years if normal, and earlier at any age with overweight plus a risk factor. The USPSTF recommends screening at 35 to 70 for adults with overweight or obesity, and says every 3 years may be reasonable after a normal result. (ADA, 2026) (USPSTF, 2021)

Does the USPSTF recommend a cholesterol test?

It has no separate cholesterol screening statement for adults. Its 2022 statin statement covers adults 40 to 75 and relies on a 10-year heart risk estimate, which uses cholesterol levels. The ACC/AHA advise measuring heart risk factors at least every 4 to 6 years from age 20. (USPSTF, 2022) (ACC/AHA, 2019)

Should men get a bone density test?

The USPSTF says the evidence for screening men is insufficient. The Bone Health and Osteoporosis Foundation recommends bone density testing for men 70 and older, and for men 50 to 69 based on their risk profile. (USPSTF, 2025) (BHOF, 2022)

Who should get an aortic aneurysm ultrasound?

The USPSTF recommends a one-time ultrasound for men 65 to 75 who have ever smoked. Medicare covers one with a referral if you have a family history of AAA, or are a man 65 to 75 who smoked at least 100 cigarettes. (USPSTF, 2019) (Medicare.gov)

Which guideline decides what my insurance covers?

Under the Affordable Care Act, most private plans must cover USPSTF grade A and B services without cost sharing. Other groups' guidelines do not carry that rule. (42 U.S.C. 300gg-13)