Heart Disease Develops Silently for Years. Cardiologist Recommends 4 Preventative Health Tests for Men Over 50

Heart Disease Develops Silently for Years. Cardiologist Recommends 4 Preventative Health Tests for Men Over 50With roughly half of U.S. adults living with some form of cardiovascular disease, it's almost a shock that routine visits to the cardiologist aren't more normalized. Unlike something like a fever or infection that may otherwise prompt a quicker visit to the doctor, heart disease develops silently, with risk factors building for years before symptoms appear. To catch potential problems before they become serious, preventive screening and regular checkups are especially important for men over 50.

"High blood pressure, high cholesterol, and elevated blood sugar can all develop without obvious symptoms," says Sirisha Vadali, MD, a board-certified cardiologist and advanced lipidologist of HonorHealth. "By the time someone feels chest pain or has a heart attack, risk factors may have been present for years. Testing gives us the opportunity to identify those risks earlier and decide what to do about them, whether that means lifestyle changes, medication, or a closer look at the arteries. I always tell patients that feeling fine doesn't necessarily mean there's nothing to address."

Additional screening may be appropriate depending on age, medical history, and overall risk. Vadali says a coronary artery calcium (CAC) scan can help determine whether plaque buildup is present and if starting a statin makes sense. For men over 65 who have ever smoked, it may also be worth discussing a one-time abdominal ultrasound to screen for an abdominal aortic aneurysm.

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When blood pressure stays high, it damages blood vessels over time, thus increasing the risk of heart attack, stroke, heart failure, and kidney disease. High blood pressure often causes no noticeable symptoms, making regular checks especially important for men over 50. Testing blood pressure is a quick matter, wrapping the cuff around your upper arm for a reading.

"Blood pressure should be checked at least annually, and more often if it's elevated or they're being treated for hypertension," Vadali says.

A lipid panel, or cholesterol panel, is a blood test that measures total cholesterol, LDL ("bad" cholesterol), HDL ("good" cholesterol), and triglycerides. High levels of LDL can contribute to plaque buildup in the arteries, which raises the risk of heart attack and stroke.

Blood sugar testing, typically through a fasting blood glucose test or hemoglobin A1C test, helps identify prediabetes and diabetes. A1C estimates your average blood sugar over the previous two to three months. Chronically elevated blood sugar damages blood vessels and contributes to plaque buildup, significantly increasing the risk of heart disease. Because the risk of type 2 diabetes increases with age, regular screening can catch problems early.

Lipoprotein(a), or Lp(a), is a cholesterol-carrying particle that can increase the risk of plaque buildup, heart attack, stroke, and aortic valve disease. Unlike LDL cholesterol, Lp(a) levels are largely determined by genetics. Testing is useful for men over 50 with a family history of early heart disease.

"Lp(a) generally only needs to be measured once because it's a largely inherited cardiovascular risk factor which isn't included in a standard cholesterol panel," Vadali adds.

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Sirisha Vadali, MD, a board-certified cardiologist and advanced lipidologist of HonorHealth

This story was originally published by Men's Journal on Oct 21, 2026, where it first appeared in the Health section. Add Men's Journal as a Preferred Source by clicking here.