Heart and blood vessel screenings by age

The heart-related checks the USPSTF recommends for adults without symptoms, by age, on one page: blood pressure, a heart risk estimate that decides on statins, blood sugar, and a one-time aortic ultrasound for some men. Then the heart tests it does not recommend as routine screening. If you have chest pain, shortness of breath or other symptoms, that is not screening: see a doctor.

By age

Heart and blood vessel screenings the USPSTF recommends, by age
Check	Who	How often	Source
Blood pressure	All adults 18 and older	Every year from 40 or if at higher risk; every 3 to 5 years for adults 18 to 39 with normal readings and no added risk	USPSTF, 2021, grade A
Heart risk estimate and statin	40 to 75 with a risk factor (high cholesterol, diabetes, high blood pressure or smoking)	A statin if your 10-year risk is 10% or more (grade B); selectively at 7.5% to under 10% (C)	USPSTF, 2022
Cholesterol test	Adults 20 and older (NHLBI)	Every 5 years for younger adults; every 1 to 2 years for men 45 to 65 and women 55 to 65; yearly after 65	NHLBI, 2024
Blood sugar (prediabetes and diabetes)	35 to 70 with overweight or obesity	Every 3 years may be reasonable if results are normal	USPSTF, 2021, grade B
Aortic aneurysm ultrasound	Men 65 to 75 who have ever smoked	Once	USPSTF, 2019, grade B

Your screening plan shows which of these apply at your age, and know your numbers explains the blood pressure, cholesterol and blood sugar ranges.

Blood pressure: every adult

The USPSTF recommends blood pressure screening for all adults 18 and older (grade A): every year from 40 or for anyone at higher risk, and every 3 to 5 years for adults 18 to 39 with normal readings and no added risk. () What the numbers mean: blood pressure readings.

Cholesterol and the statin decision: 40 to 75

The USPSTF does not grade cholesterol testing on its own. Instead it recommends a statin for adults 40 to 75 with no history of heart disease who have at least one risk factor (high cholesterol, diabetes, high blood pressure or smoking) and a 10-year risk of a heart attack or stroke of 10% or more (grade B), and selectively at 7.5% to under 10% (grade C). The risk estimate it points to, the ACC/AHA Pooled Cohort Equations, uses cholesterol results. From 76 the evidence is insufficient (I). (USPSTF, 2022)

For how often to test cholesterol, the NIH's heart institute gives every 5 years for younger adults, every 1 to 2 years for men 45 to 65 and women 55 to 65, and every year after 65. (NHLBI, 2024) More on cholesterol tests by age and statins.

Blood sugar: 35 to 70 with overweight

Diabetes raises heart risk. The USPSTF recommends screening for prediabetes and type 2 diabetes at 35 to 70 in adults who have overweight or obesity (grade B), and says every 3 years may be reasonable if results are normal. ()

Aortic aneurysm: once, for men 65 to 75 who have smoked

A one-time ultrasound of the aorta for men 65 to 75 who have ever smoked (grade B). () The rules for other groups are on screenings if you smoke.

Heart tests the USPSTF does not recommend as routine screening

These apply to adults without symptoms. A doctor may still order any of them to look into symptoms or a known condition; that is diagnosis, not screening.

Heart and blood vessel tests the USPSTF grades D or I for screening adults without symptoms
Test	Who	USPSTF says	Source
Resting or exercise ECG	Low heart risk	Do not screen (D)	USPSTF, 2018
Resting or exercise ECG	Intermediate or high heart risk	Evidence insufficient (I)	USPSTF, 2018
Coronary artery calcium (CAC) score, ankle-brachial index, hsCRP added to the risk estimate	Adults without symptoms	Evidence insufficient (I)	USPSTF, 2018
Ankle-brachial index for peripheral artery disease	Adults without symptoms	Evidence insufficient (I)	USPSTF, 2018
Carotid artery ultrasound	General adult population	Do not screen (D)	USPSTF, 2021
Atrial fibrillation screening	Adults 50 and older without symptoms	Evidence insufficient (I)	USPSTF, 2022

What D and I mean: USPSTF grades explained. Other tests you may not need are on screening tests you may not need.

Questions people ask

What heart screenings do I need at 40?

A blood pressure check every year from 40, and a heart risk estimate from 40 to 75 to see whether a statin would help; that estimate uses a cholesterol test. From 35, a blood sugar test if you have overweight or obesity. () (USPSTF, 2022) ()

Should I get an ECG as part of a checkup?

Not if you are at low risk and have no symptoms: the USPSTF recommends against a resting or exercise ECG for screening (grade D). For people at intermediate or high risk it finds the evidence insufficient (I). (USPSTF, 2018)

Is a coronary calcium (CAC) scan recommended?

The USPSTF finds the evidence insufficient to add a CAC score, an ankle-brachial index or hsCRP to the usual heart risk estimate in adults without symptoms (I statement). Ask your doctor whether it would change your treatment. (USPSTF, 2018)

How often should I get my cholesterol checked?

The NIH heart institute (NHLBI) gives every 5 years for younger adults, every 1 to 2 years for men 45 to 65 and women 55 to 65, and every year after 65. The USPSTF does not set its own interval. (NHLBI, 2024)