Check-ups: what are they and how often are they needed?

What do we have a check-up for?

A check-up is not for illness; it is for before illness. Many common middle-age problems, such as high blood pressure, high blood sugar or blood fats, move forward silently for years and give symptoms only when some time has passed since they began. Estimates show that about 44% of adults with high blood pressure do not know they have it. A check-up means looking at these silent problems before they show themselves.

What does a check-up take into account?

A check-up is not a fixed package. The screening tests differ for each person with age, sex, family history and risk factors. The conditions usually considered in these assessments include high blood pressure, high blood fats and diabetes. A simple example of how it works: in some countries there is a programme for adults aged 40 to 74 without known heart and vessel disease, which measures height, weight and waist size, blood pressure, cholesterol and sometimes blood sugar, asks about family history and habits such as smoking and activity, and at the end estimates the ten-year risk of heart and vessel disease. This programme is repeated every 5 years. This is only an example, not a recommendation for you.

For you, the combination and the interval of check-ups is set by the doctor based on your age, earlier illnesses, medicines and risk factors. If you want to know “how often should I have a check-up?”, ask the doctor exactly that and write down the answer.

Tests that may come up in a check-up

Depending on the situation, the doctor may ask for some of these:

• Blood pressure. It is a simple measurement and can show a problem without any symptom.
• Blood sugar. With HbA1c or fasting blood sugar. The limits are in the guide “Preparing for a blood test and reading the result”.
• Blood fats. To see cholesterol, LDL, HDL and triglycerides.
• Height, weight and waist size.
• Other tests, if the doctor thinks they are needed based on your symptoms or history.

This list means “some possibilities”, not “the required package”.

What are your risk factors?

A family history of heart disease, age, high blood pressure or blood sugar or blood fats, excess weight, inactivity, smoking, and a high-salt, high-fat diet are known risk factors. Some of them (age, family history) cannot be changed; the rest can. If you have several factors together, a check-up matters more for you and is probably needed more often. The doctor will tell you this according to your situation.

What should you do before a check-up?

• Ask whether fasting is needed.
• Take the list of medicines, supplements and earlier test results.
• Write down the family history of heart disease, stroke, diabetes or high blood pressure, and the ages at which it happened.
• Mention the small symptoms you have ignored: tiredness, shortness of breath on walking, stomach burning, weight change.

If I have a check-up and everything is fine, is that the end?

A normal check-up is good news, but it is not a guarantee of health for ever. If you develop a new symptom later, do not wait for the next check-up. The symptoms for which you should call immediately are in the section “When should I call urgently?” of the patient guide.