A preventative cardiologist has outlined four essential health checks that every woman should have once she reaches the age of 40. Dr Francesco Lo Monaco, founder of The National Heart Clinic in London, emphasises that these tests can detect potential cardiovascular problems before symptoms appear, helping to reduce the risk of heart attacks, stroke, and other conditions.
Heart Disease: A Leading Threat to Women
The British Heart Foundation (BHF) warns that coronary heart disease, the main cause of heart attacks, kills twice as many women as breast cancer in the UK each year. Despite this, the charity notes that many women ignore heart attack signs or report less intense symptoms than men. Dr Lo Monaco stresses that regular checks are vital for early identification of risk factors.
“Heart disease remains a leading cause of death for women, yet many are unaware of the risk,” he said. “Regular checks are vital in identifying problems early, often before symptoms appear. By monitoring key indicators, women can take proactive steps to reduce their risk of heart attacks, stroke, and other cardiovascular conditions.”
The Four Essential Tests at 40
Dr Lo Monaco advises that these four tests should be standard for women at age 40 with no known risk factors. Earlier screening is recommended for those with a family history of premature cardiovascular disease, pregnancy complications, autoimmune disease, or other risk factors.
1. Blood Pressure Check
Blood pressure measurement indicates the pressure of blood in the arteries. High readings can signal hypertension, where blood pressure remains elevated even at rest. This condition can stiffen or narrow arteries, increasing the likelihood of heart attacks or stroke. Since high blood pressure has no obvious symptoms, Dr Lo Monaco recommends checking it at least yearly, or more often if results are elevated or borderline.
2. Lipid Profile (Cholesterol Panel)
A lipid profile measures cholesterol levels. Elevated cholesterol heightens the risk of heart attack or stroke. Dr Lo Monaco advises that this test should be done every five years if results are normal, or more frequently if abnormal or the patient is high-risk.
3. Fasting Glucose Test and HbA1c
These tests measure blood sugar levels and are standard for detecting diabetes. Dr Lo Monaco recommends they be performed every three years if normal, or annually if the patient is prediabetic or high-risk.
4. BMI and Waist Circumference
A BMI test calculates body mass index to assess healthy weight. However, since BMI is not always accurate, Dr Lo Monaco also advises annual waist circumference measurement. “A waist circumference greater than 35 inches (88 cm) can indicate increased risk of cardiovascular disease,” he said.
Women-Specific Risk Factors Often Overlooked
Dr Lo Monaco highlights that traditional risk factors—hypertension, high cholesterol, diabetes, smoking, obesity, sedentary lifestyle, and family history—apply to everyone. But women have additional risk factors that are frequently missed: pregnancy complications such as preeclampsia and gestational diabetes, early menopause, Polyendocrine Metabolic Ovarian syndrome (PMOS), autoimmune diseases, and history of breast cancer treatment. Psychological and inflammatory factors—chronic stress, depression, anxiety, poor sleep, and chronic inflammation—also deserve attention in cardiovascular risk assessment.
When to Seek Help: Symptoms Not to Ignore
Dr Lo Monaco warns that persistent symptoms should not be dismissed even if initial tests are normal. “You are your best advocate. Persistent symptoms deserve thorough evaluation, not dismissal,” he said. He stresses that heart attack symptoms can differ between men and women. “If you experience unexplained, persistent fatigue that’s not normal for you, especially if accompanied by breathlessness, nausea, or discomfort anywhere in your upper body, don’t dismiss it. Call your doctor. If it’s severe or sudden, go to A&E.”
Additional warning signs include: breathlessness (especially new or worsening), pain in the jaw, neck, shoulders, back, or upper abdomen, nausea or vomiting with upper body discomfort, dizziness or lightheadedness, cold sweats, and a sense that something is seriously wrong.
