Start with the basics: blood pressure, a cholesterol panel, blood sugar and your family history. They do most of the work. ApoB and a one-time Lp(a) test add useful detail for some people, and a heart scan helps most when your risk sits in the middle and a decision could go either way.
The tests, in plain English
Think of your arteries like the pipes in a house. Blood tests show how much is flowing through that could clog them. A heart scan looks inside the pipes for buildup that's already there.
Blood pressure
The biggest single number for heart risk. It measures how hard your blood pushes on your artery walls, and high pressure wears them down over time. Quick, cheap, and worth repeating at home to confirm a high reading.
For: Every adultCholesterol panel
It shows how much cholesterol and fat are in your blood, which is what slowly builds up as plaque. LDL, HDL and triglycerides are the starting point for almost every heart conversation.
For: Every adultApoB
Counts the particles that actually get stuck in artery walls. Think of it as counting the delivery trucks, not just weighing what they carry. It can flag risk when a regular panel looks fine.
For: Anyone wanting a closer look, or with borderline numbersLp(a)
An inherited marker that raises heart risk on its own, even when your other numbers look healthy. Your level barely changes, so most people only need it tested once.
For: Anyone with heart disease early in the familyCalcium score
A quick CT scan that shows hardened plaque already sitting in the heart's arteries. You get a number: zero means none was found, and higher means more buildup.
For: People whose risk is borderline and a decision is closeCoronary CT angiogram
A more detailed scan that shows soft and hard plaque, plus any narrowing. A dye goes in through an IV so the scan can show how open each artery is.
For: Usually when a doctor thinks more detail would change the planHeart health in San Francisco, by the numbers
The rate of high blood pressure in San Francisco is lower than the national rate. In San Francisco, 29.2% of adults have high blood pressure, compared with 34.4% nationally. That adds up to roughly 1,080,000 adults across five counties.
CDC estimates. PLACES figures are modelled from a national health survey, not counted from medical records, so read them as estimates.
See how the five counties compare
| County | High blood pressure | High cholesterol (of those checked) | Coronary heart disease |
|---|---|---|---|
| Alameda | 28.5% | 33.4% | 4.8% |
| Contra Costa | 31.2% | 36.1% | 5.5% |
| San Francisco | 27.0% | 35.2% | 4.9% |
| San Mateo | 29.2% | 37.4% | 5.2% |
| Marin | 32.6% | 37.3% | 6.4% |
| San Francisco | 29.2% | 35.3% | 5.1% |
| United States | 34.4% | 36.4% | 6.3% |
Source: CDC PLACES, 2023 county estimates. San Francisco = San Francisco, Alameda, Contra Costa, San Mateo and Marin counties, weighted by adult population.
longevityclinicshub.comBlood pressure and cholesterol are part of an ordinary checkup, so your regular doctor is the place to start. The tests above add detail once you know those basics.
