Middle-age tests: Cardiovascular disease

September 07, 2000

Middle-age tests: Cardiovascular disease

It's the big one.

Nearly 60 million Americans have one or more types of cardiovascular diseases, which include high blood pressure, coronary heart disease and stroke.

Cardiovascular diseases are the No. 1 killer of women and men. Although heart disease often is considered "a man's disease," cardiovascular diseases claim the lives of more than half a million women every year - more deaths than the next 14 causes combined, according to American Heart Association.

Risk factors include high blood cholesterol, physical inactivity and being overweight. Women with diabetes are at higher risk than men with diabetes.


Estrogen protects women from heart disease. When the ovaries stop producing estrogen during menopause, the protection is lost, and women are as likely to have heart attacks as men.

HEIGHT="6" ALT="* "> Blood pressure

Blood pressure is typically recorded as two numbers: systolic pressure - as the heart beats; over diastolic pressure - as the heart relaxes between beats. Blood pressure at all ages should be kept below 140/90, according to National Heart, Lung and Blood Institute of National Institutes of Health.

In people who are middle-aged or older, systolic blood pressure - the top number - becomes a better risk indicator for heart disease and stroke.

About 50 million Americans ages 6 and older have high blood pressure. A quarter of American adults have high blood pressure. Blood pressure screening should be started at age 3 and done at least annually through life, recommends Dr. Brian Bonham of Myersville Internal Medicine and Pediatrics in Myersville, Md.

HEIGHT="6" ALT="* "> Diabetes

There are 15.7 million people in the United States with diabetes, a disease that affects the way the body uses food.

If a person has diabetes, the body makes no insulin or not enough to convert sugar into energy to fuel the body.

Over time, high blood sugar can lead to heart attacks and strokes, as well as kidney failure, blindness and amputations.

Diabetes is a serious disease that is prevalent and insidious, Bonham said. "I strive to screen annually." He doesn't wait until his patients are middle-aged. He starts screening healthy people with no family history of diabetes at about age 35. He recommends screening tests as early as age 25 for patients who are obese or who have a family history of the disease.

The screening is a simple, fasting blood test.

Risk factors:
HEIGHT="6" ALT="* "> Middle age - 45 and older

HEIGHT="6" ALT="* "> High-risk ethnic groups, including African-American, Hispanic/Latino, American Indian, Asian-American, Pacific Islander

HEIGHT="6" ALT="* "> Overweight

HEIGHT="6" ALT="* "> Family history of diabetes

HEIGHT="6" ALT="* "> History of diabetes during pregnancy or having a baby weighing more than 9 pounds at birth.

HEIGHT="6" ALT="* "> Cholesterol

If a patient has a normal lipid panel, Bonham recommends screening every three to five years. If test results are abnormal or borderline, he screens more frequently.

- American Heart Association, American Medical Association, American Diabetes Association

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