Cardiovascular disease remains one of the leading causes of illness, disability, and death in the UK and worldwide, and in some people, risk exists despite feeling completely well and having no symptoms.
As Dr Simon Pearse, Consultant Cardiologist at New Victoria Hospital, explains, understanding your personal risk and having a heart health assessment is an important step towards preventing future heart problems and protecting your long-term wellbeing.
Why early heart health checks matter
Today in the UK, over 8 million people live with Cardiovascular Disease, posing significant risks to health and life. It is hard to correctly estimate, but available data suggest that tens of millions of people worldwide are living with some form of subclinical cardiovascular disease (CVD) or are at high risk of developing CVD without knowing it.
Many serious heart conditions, such as Coronary Artery Disease (CAD), also known as Ischaemic Heart Disease (IHD), Atrial Fibrillation (AF), Hypertension, raised cholesterol, and others, can be "silent" in their early stages, showing no obvious signs, while slowly causing damage to your heart or exposing you to risk.
Even heart attacks can sometimes be silent, causing only mild, vague, or no symptoms at all. These subtle signs are often mistaken for indigestion, fatigue, or muscle strain. These events still damage the heart muscle and increase the risk of future, more serious cardiac events
Heart disease can also affect otherwise healthy individuals dedicated to healthy lifestyles and sports, even to professional level. A routine heart health check and a review with a Cardiologist can help discover your risk factors and silent conditions before they have caused any lasting damage and start a timely prevention or treatment plan if needed.
Who should consider a heart screening?
If you are over the age of 40, even if you feel fit and well, you may benefit from a one-off or periodic review of your cardiovascular risk. Screening can also be helpful for younger patients with multiple risk factors, particularly if you have a family history of heart disease or stroke.
People with sedentary jobs, high levels of stress and other psychological risk factors, or weight gain around the abdomen or adiposity, often underestimate their cardiovascular risk, despite clear evidence that these factors contribute to long-term heart problems.
Cardiac screening can also provide reassurance and a safe baseline from which to build for those planning to increase exercise intensity, return to sport, or start a vigorous fitness programme in mid-life.
“One of the most common things people say in clinic is, “I feel fine – I didn’t think I was at risk". A cardiac screening that includes a consultation with a Cardiologist allows us to uncover silent risk factors, understand what they mean for you, and put a practical plan in place to reduce the chance of future heart problems.” Dr Simon Pearse, MD(Res) MBChB BSc (Hons)
Risk factors for cardiovascular diseases
Nonmodifiable risk factors
Age
Risk of cardiovascular diseases (CVD) rises steadily with age, particularly after 40–50, as arteries become stiffer and long-term exposure to other risks accumulates. Stroke, heart failure and peripheral arterial disease all become more common in older adults, not just coronary artery disease (CAD).
Sex / gender
Men tend to develop cardiovascular disease earlier in life, often around 10 years before women, partly due to hormonal protection from oestrogen and patterns of risk behaviours such as smoking and alcohol use.
After menopause, women’s risk rises sharply and often catches up with men, and women can experience worse outcomes after events such as heart attack and heart failure.
Women also may have additional or unique risk markers, such as a history of preeclampsia, gestational diabetes, pregnancy-related hypertension or early menopause, all of which are associated with higher CVD risk later in life.
Sex and gender influence how symptoms are experienced, how quickly people seek care and how healthcare systems respond, so tailored assessment and communication are important in both clinical care and patient education.
Ethnicity
Certain ethnic groups have higher CVD rates, including South Asian, Black and some Hispanic/Latino populations, with increased risks of hypertension, diabetes and stroke as well as CAD. These differences reflect a complex mix of genetics, social determinants of health and differential access to prevention and care.
Family history and genetics
A family history of premature atherosclerotic CVD (heart attack, stroke or sudden cardiac death in a first-degree relative at a young age) increases risk beyond traditional factors. Inherited conditions such as familial hypercholesterolaemia or cardiomyopathies can drive early heart disease, not only coronary artery disease.
Modifiable risk factors
Hypertension
High blood pressure is one of the strongest risk factors for CVD, contributing to CAD, stroke, heart failure, atrial fibrillation and chronic kidney disease. Even mildly raised levels increase long-term risk, yet a large proportion of adults remain undiagnosed or inadequately controlled worldwide.
Dyslipidaemia (hyperlipidaemia)
High LDL cholesterol and triglycerides, and low HDL cholesterol, drive atherosclerosis in coronary, cerebral and peripheral arteries. Treating dyslipidaemia reduces heart attacks and strokes and may also help prevent progression of peripheral arterial disease.
Diabetes mellitus and prediabetes
Type 1 and type 2 diabetes markedly increase the risk of CAD, stroke, heart failure, and peripheral arterial disease, partly through endothelial dysfunction and accelerated atherosclerosis. Even prediabetes and metabolic syndrome are linked with higher CVD risk, particularly when combined with obesity and hypertension.
Overweight and obesity
Excess body weight independently raises CVD risk and amplifies other factors such as hypertension, dyslipidaemia, insulin resistance and sleep apnoea. Obesity is associated with heart failure, atrial fibrillation and structural heart disease as well as CAD and stroke.
Smoking and tobacco exposure
Both active smoking and second-hand smoke increase the risk of myocardial infarction, stroke, peripheral arterial disease, aortic aneurysm and sudden cardiac death. Tobacco promotes thrombosis, endothelial dysfunction and arrhythmias, and there is no safe level of exposure for cardiovascular health.
Unhealthy diet
Diets high in saturated and trans fats, added sugars, salt, and ultra-processed foods increase blood pressure, cholesterol and weight, as well as disrupt your gut microbiome, thereby raising risk of inflammation, heart attack and stroke. High intake of red and processed meats and sugar-sweetened beverages is linked with higher CVD incidence, while diets rich in vegetables, fruits, whole grains and unsalted nuts are protective.
Physical inactivity / sedentary behaviour
Low levels of physical activity and prolonged sitting are associated with higher rates of CAD, stroke, heart failure and cardiovascular mortality. Regular moderate-to-vigorous exercise improves blood pressure, lipid profile, insulin sensitivity and weight, reducing overall CVD risk.
Harmful alcohol use
While low consumption of red wine has proven health benefits for a certain group of people, excessive use raises blood pressure and triglycerides and contributes to cardiomyopathy, arrhythmias and stroke. Binge drinking in particular is associated with atrial fibrillation and sudden cardiac events.
Psychosocial stress, depression and sleep
Chronic stress, depression and poor sleep quality are associated with a higher incidence of CAD, stroke and arrhythmias, likely through neurohormonal and behavioural pathways. Stress can worsen blood pressure control, promote unhealthy coping behaviours (smoking, overeating) and impair adherence to preventive treatment.
Air pollution
Long-term exposure to fine particulate matter (PM2.5) and traffic-related pollution increases the risk of heart attack, stroke and heart failure. Mechanisms include systemic inflammation, oxidative stress and effects on vascular function and coagulation.
Wider health factors
Cardiovascular risk is not shaped by blood pressure, cholesterol and lifestyle alone. Clinicians also recognise that certain long-term health conditions can be associated with a higher risk of heart disease, such as nonalcoholic fatty liver disease (NAFLD), chronic kidney disease, chronic inflammatory and autoimmune conditions, COPD and other chronic lung diseases, as well as hormone or thyroid disorders. The research to understand these links is ongoing.
On their own, these conditions do not necessarily indicate high cardiovascular risk. Rather, they are additional factors to consider alongside well-established risks when deciding whether cardiac screening may be helpful.
What does the Cardiac Screening involve?
Cardiac screening at New Victoria Hospital is designed for people who feel well but want a clearer picture of their heart health and future risk.
Health & Lifestyle Questionnaire: Completed before your appointment, covering family history, existing conditions, medications, smoking, physical activity and other factors that influence cardiovascular risk.
Blood pressure measurement: A quick, non-invasive check to assess your current blood pressure and identify any levels that could increase your risk of heart disease or stroke.
Electrocardiogram (ECG): A painless test that records your heart’s electrical activity in just a few minutes, helping to detect rhythm disturbances or early signs of strain on the heart.
Cardiology consultation: A Consultant Cardiologist reviews your questionnaire, test results and any recent blood tests, estimates your short- and long-term cardiovascular risk, and offers personalised advice on lifestyle changes, further cardiac tests or medical treatment where appropriate.
When a full cardiology review is needed
Cardiac screening is intended for adults without symptoms who'd like reassurance or an assessment of future risk. Anyone experiencing any symptoms inclusive of chest pain, breathlessness on exertion, palpitations, blackouts or unexplained dizziness should instead book a full consultation with our Cardiology Consultants, offering a longer, more personalised consultation tailored to your needs.
Additional tests and investigations may be required to further assess your heart health, including echocardiograms or Exercise Treadmill Tests, or advanced cardiac imaging. New Victoria Hospital’s Cardiology team offers a comprehensive diagnostic pathway, allowing patients to move efficiently from assessment to the most appropriate investigations and treatments when required.
Taking the next step
If you feel well but want to understand your heart health, the Cardiac Screening Service at New Victoria Hospital provides a straightforward pathway to clarity and peace of mind. For many patients, simply having their risk factors mapped out clearly – and understanding how individual changes can alter that risk – acts as a powerful motivator to make and sustain healthier choices.
This approach reflects the growing emphasis on prevention in modern cardiology – shifting the focus from reacting to heart disease to identifying and managing risk earlier. As Dr Simon Pearse explains, the aim is not to create anxiety, but to give people confidence that they understand their heart health and are taking sensible steps to protect it for the future.
If you are feeling well but would like reassurance about your heart health, you can arrange Cardiac Screening at New Victoria Hospital.
If you are experiencing cardiovascular symptoms or have existing concerns, please call 020 8949 9020 or fill in the online contact form to book an appointment with our Cardiology Consultants.
