Doctor examining elderly woman with elbow pain

Ask a cardiologist: Annual physical

Q: My annual physical is coming up. Will my doctor be screening me for heart disease?

A: Not likely. But your doctor will be looking for risk factors. That’s because nearly 80 percent of premature heart disease and stroke is preventable. So if we can identify the known risk factors, we can stop heart disease in its tracks.

The most common risk factors include:   

  • High blood pressure
  • Smoking
  • High cholesterol
  • Diabetes
  • Being overweight
  • Stress

Traditionally doctors screen for these risk factors using: a scale, blood pressure cuff, measuring tape for your waist circumference, and then ordering a series of blood tests for cholesterol and blood sugar. This will give doctors a clear indication if you’re at high or low risk. Doctors will also ask about daily consumption of fruits and vegetables, regular physical activity, and alcohol consumption which are other important factors related to developing heart disease.

Occasionally, screening reveals grey areas when a patient isn’t at risk today but could be in 10, 20 or 30 years and could benefit from medication. If your doctor is uncertain about starting medication these additional tests can serve as a tiebreakers.

  • The high sensitivity C-Reactive Protein, or hsCRP is a marker that’s correlated with heart disease risk and is produced when there’s inflammation present in the body. Inflammation can come from a variety of sources, an injury (arthritis, for example) or an unhealthy lifestyle. Smoking or being overweight can increase low levels of inflammation in your blood stream. Inflammation circulating in your blood can be measured with the hsCRP and levels have been linked to increased heart disease and stroke risk. A simple blood test is all that’s needed to screen for hsCRP and add another component to your risk assessment.

  • CT angiograms are CT scans that are so high resolution they can measure the blood flow of your arteries and to what extent there are calcium deposits lining your arteries.

  • A calcium score, which can be calculated from a CT angiogram, is a measure of the degree of calcium deposits in your coronary arteries. Calcium deposits are minerals found in hardened arteries (atherosclerosis). Studies show that the calcium score is a marker of underlying atherosclerosis, which has been shown to correlate with your risk for future cardiac events, particularly heart attacks. Calcium scores do have a specialized role, particularly if someone has a very strong family history, such as a parent dying from heart disease at age 40 or 50 even if their own health is fine and they show no signs of any other traditional cardiovascular risk factor described above.

Should any test reveal a risk factor don’t be alarmed. Most Canadians have at least one risk factor that they can reduce back to normal, usually with a healthy diet and exercise. Other risk factors after a trial of diet and exercise may require medication to treat and control.

A checkup is a great opportunity to take control of your health. Get comfortable asking your doctor about how you can be healthier–including advice on reducing your risk of heart disease and stroke. Diet, cholesterol and high blood pressure are just some of the risk factors you can do something about. 


  • Do you have a question for our cardiologist? Send it to Unfortunately we cannot provide personal replies. Questions of general interest will be answered in future Heart and Stroke Foundation publications.


This article is for informational purposes only and is not a substitute for medical advice, a medical diagnosis or treatment from a physician or qualified healthcare professional. The Heart and Stroke Foundation of Canada assumes no responsibility or liability arising from any error in, or omission of, information, or from the use of any information or advice contained in this article.


6 Responses

  1. zora varga

    Hi, I am 70 years old, and 4 years ago had a heart attack, the arterie was blocked and I’ve received two stents.
    I have a question:Can I purchase Vitapulse, it is supposed to clean arteries from inflammation ?
    I also have a history of heart failures on my mom’s side of the family.
    Thank you so much.
    Zora Varga

    1. Sharon Hollingsworth

      Hi Zora,
      Thank you for your comment on the Heart and Stroke Foundation’s blog. We are always pleased to hear from our readers. Unfortunately, while the Foundation provides Canadians with general information on heart disease and stroke, we are unable to offer specific medical advice. I strongly recommend that you check with your healthcare provider who will be better able to answer your question. Thanks again for checking in and best wishes for improved health! Sincerely, Sharon at the Heart and Stroke Foundation

  2. dave belland

    I do appreciate informational emails from The Heart and Stroke Foundation and I totally agree that it’s important to be proactive when dealing with heart health issues especially at my age(64)
    Although I do have a familly doctor, he is ill equiped to give me a complete heart check-up in fact he is preatty much useless in this regard (just my opinion)
    Is there anywhere in Montreal where I could schedule an appointment without spending a small fortune and get a complete heart check-up?


    1. Sharon Hollingsworth

      Hello Dave and thanks for your comment on our blog. We’re glad to hear that you are being proactive regarding your heart health. A good place to start in finding out where you might be able to book the appointment you mention would be the Quebec Medical Association in Montreal. You can reach them by phone at 514 866-0660 or by email at

      Thanks again for your note, Dave. I hope this information I’ve provided proves helpful! Sincerely, Sharon at the Heart and Stroke Foundation

  3. marlie

    I’ve asked the doctor I met recently to provide me with the HDL/LDL results and she said all you need to know is the Non HDL which i have as being 4.86. I don’t know if heart disease is in the family. I am now in menopause, 55 years young, h/r is averaging 65 and b/p 98/70. I have gone up in weight from 140 to 190 in 6 months and still walk but weight is not coming off. don’t smoke or drink; have practially no red meat and eat chicken occassionally; eat no white bread; lots of grains, nuts and still i have a high Non HDL. what can I do? I don’t drink soda or much alcohol..once in a month or two socially.

    1. Sharon Hollingsworth

      Hi Marlie,
      Thank you for sharing your concerns related to the imformation in the Heart and Stroke blog post. It certainly seems that you are doing a lot rignt in terms of your heart health. But since your difficulty in achieving a healthy weight is your ongoing challenge, I suggest you may want to ask your doctor for a referral to a dietitian who should be able to suggest strategies to help you get back on track.

      Thanks again for reaching out, Marlie and best of luck with this!

      Sincerely, Sharon at Heart and Stroke

We welcome your comments on our posts, but ask that you refrain from using profanity and remain courteous and respectful of others' opinions. The Heart and Stroke Foundation reserves the right to remove any comments that are not in compliance with this policy.

Leave a Reply