Heart Health Screening: What It Checks and Who Should Have One

In short: Heart health screening checks the main risk factors for heart disease and stroke, such as blood pressure, cholesterol, blood sugar, weight and smoking, often before any symptoms appear. Clinicians combine these results to estimate your 10-year risk of a heart attack or stroke (usually with a tool called QRISK3). In England, adults aged 40 to 74 are offered a free NHS Health Check every five years. Chest pain, breathlessness or palpitations are not a reason to wait for a check-up: seek medical advice promptly, and call 999 for suspected heart attack.

This guide, written by a Ready Health prescribing pharmacist, explains what heart health screening involves, who should consider it, and which symptoms need urgent attention.

Why does heart health screening matter?

Cardiovascular disease is one of the leading causes of death in the UK. Many of its main drivers, especially high blood pressure and high cholesterol, cause no symptoms at all. Finding them early gives you time to make lifestyle changes and, where appropriate, discuss treatment with a clinician.

What does a heart health check involve?

Do I need an ECG or heart scan?

Not usually, if you have no symptoms. Tests such as an ECG (electrocardiogram) or an echocardiogram (heart ultrasound) are most useful when there is a clinical reason, for example palpitations, breathlessness, a heart murmur, an abnormal pulse, or before starting certain medicines. A clinician can advise whether these tests would help in your situation.

Who should consider a heart health check?

• Adults aged 40 and over, especially if you have not had a recent check
• People with a family history of early heart disease (a parent or sibling affected before 60)
• People who smoke, are living with obesity, or are physically inactive
• People with diabetes, kidney disease or high blood pressure
• People of South Asian or Black African or African-Caribbean family background, who have a higher risk of some cardiovascular conditions
• Anyone with a known inherited cholesterol condition (familial hypercholesterolaemia) in the family

What happens if my results are abnormal?

Your clinician will explain what the results mean and agree next steps. This might include repeat tests, home blood pressure monitoring, lifestyle advice, or a referral to your GP or a specialist. NICE guidance sets out when medicines such as statins or blood pressure treatment should be offered, and a prescriber will discuss the benefits and risks with you.

How can I look after my heart?

• Stop smoking; free NHS support is available
• Aim for at least 150 minutes of moderate activity a week
• Eat plenty of fruit, vegetables, wholegrains and oily fish, and cut down on salt and saturated fat
• Keep alcohol within 14 units a week, spread over several days
• Maintain a healthy weight and get enough sleep

Which heart symptoms should I never ignore?

• Call 999 for chest pain or pressure that spreads to the arms, jaw, neck or back, especially with sweating, sickness or breathlessness.
• Call 999 for signs of a stroke: face drooping, arm weakness or speech problems.
• See a GP promptly for breathlessness on exertion, palpitations, fainting, swollen ankles or chest discomfort on exercise.

Frequently asked questions

How often should I check my blood pressure?

Adults over 40 should have it checked at least every five years, and more often if it is borderline or you have other risk factors. Many pharmacies offer free checks.

What is a healthy cholesterol level?

There is no single target for everyone. Your clinician looks at your cholesterol alongside your other risk factors to work out your overall risk.

Is an NHS Health Check the same as heart screening?

The NHS Health Check covers the main cardiovascular risk factors for people aged 40 to 74. Private checks may offer more flexibility or additional blood tests.

Can a normal ECG rule out heart disease?

No. A resting ECG can be normal even when coronary heart disease is present, which is why symptoms should always be assessed.

Key takeaways

• The main heart risk factors usually cause no symptoms.
• A heart health check looks at blood pressure, cholesterol, blood sugar, weight and lifestyle to estimate your risk.
• ECGs and scans are generally used when there is a clinical reason.
• Never wait for a check-up if you have chest pain or stroke symptoms: call 999.

Sources and further reading

• NHS: NHS Health Check
• NHS: Cardiovascular disease
• NICE NG238: Cardiovascular disease risk assessment and reduction
• British Heart Foundation

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own clinician.

If you are in Wigan, Standish or nearby and would like your heart health risk factors checked, find out more about our blood test packages, ECG service and cardiology consultations.