Cardiac Risk Blood Test

It measures the things in your blood that cause arteries to narrow over years: cholesterol, particularly LDL and non-HDL, which build up in artery walls; blood sugar, measured as HbA1c, because diabetes and pre-diabetes accelerate that process; and high-sensitivity CRP, a marker of low-grade inflammation that makes plaques more likely to rupture. Together they estimate your risk of a heart attack or stroke in the coming years and show which factor to work on. What it cannot tell you is whether your heart muscle is currently damaged or whether an artery is already blocked; that needs an ECG, a troponin test or a scan.

No. A heart attack is diagnosed with a troponin blood test and an ECG in hospital, within hours of symptoms, and this test does not measure troponin. If you have chest pain, pressure or tightness, pain spreading to the arm, jaw or back, breathlessness, sweating or nausea, call 999 now. This test is for people who feel well and want to know their long-term risk, or who have had a scare and want to understand and reduce the factors behind it once the emergency is over.

For this test, yes: 8 to 12 hours with nothing but water, so book a morning appointment or take the kit sample before breakfast. Fasting matters mainly for triglycerides, which rise for several hours after a meal, and it keeps the results comparable with the reference ranges. Take your usual medication. Eat normally the night before rather than avoiding fat or eating unusually well; you want the result to reflect your typical diet, not your best day.

Your normal evening meal, finished 8 to 12 hours before the sample. Do not have a large, fatty or alcoholic meal, which pushes triglycerides up for longer than 12 hours, and do not eat unusually healthily either, since that gives a flattering result that does not reflect your risk. Water is fine overnight and in the morning; black tea or coffee without milk or sugar is acceptable for most laboratories, but avoid it if you can.

Your GP report interprets all eight together, but the guide values are: total cholesterol ideally below 5 mmol/L, LDL below 3, non-HDL below 4, HDL above 1 for men and 1.2 for women, total cholesterol to HDL ratio below 4, and triglycerides below 1.7 fasting. HbA1c below 42 mmol/mol is normal, 42 to 47 pre-diabetes, 48 and above diabetes. High-sensitivity CRP below 1 mg/L is low cardiovascular risk, 1 to 3 average, above 3 higher; it is only meaningful when you are otherwise well, as any infection raises it.

Non-HDL is your total cholesterol minus the protective HDL, so it captures all the cholesterol carried in particles that can damage arteries, not just LDL. NICE now uses non-HDL rather than LDL as the main target, because it includes the cholesterol in triglyceride-rich particles that LDL misses, and it does not need a fasting sample to be accurate. A non-HDL below 4 mmol/L is the usual target; below 2.5 for people who already have heart disease.

Because cholesterol is only one of the three big modifiable drivers of heart disease. Type 2 diabetes roughly doubles heart attack risk and pre-diabetes raises it, and HbA1c finds both years before symptoms. Chronic low-grade inflammation, measured by high-sensitivity CRP, independently predicts heart attacks and strokes even when cholesterol is normal, and helps decide how aggressively to treat borderline cholesterol. A cholesterol-only test misses both.

The GP report tells you which factor is driving your risk. Raised LDL and non-HDL respond to replacing saturated fat with unsaturated, more fibre, weight loss, exercise and, where lifestyle is not enough, statins, which your GP can prescribe. Raised triglycerides respond to cutting sugar, refined carbohydrate and alcohol. Raised HbA1c responds to weight loss and activity, and pre-diabetes can be reversed. Raised CRP falls with weight loss, exercise, stopping smoking and treating gum disease. Retesting after three months shows what has worked.

The NHS Health Check, offered every five years from 40 to 74, measures total and HDL cholesterol and sometimes HbA1c, alongside blood pressure and BMI, and gives a ten-year risk score. This test adds LDL, non-HDL, triglycerides and high-sensitivity CRP, can be taken at any age, and is available now rather than by invitation. Our Cholesterol Blood Test (£49) covers the six lipid markers alone; this test adds HbA1c and CRP for £10 more on the kit.

Yes. Our Enhanced Cholesterol Blood Test (£189), an advanced lipid profile, adds ApoB, which counts the artery-damaging particles directly, lipoprotein(a), an inherited risk factor that one in five people carry, ApoA1 and PLAC activity. It is the right choice if you have a family history of early heart disease or a normal cholesterol result that does not match your family history. For most people, this cardiac risk test is the right first step.

The kit is posted to you with lancets, a collection tube, plasters, instructions and a prepaid return envelope. Before breakfast, after an overnight fast, wash your hands in warm water, prick a fingertip, fill the tube to the line and post it back the same day. All eight markers are reported from the sample. Or book a morning appointment at one of 250+ clinics, or a nurse home visit.

Results are emailed within 3 to 5 working days of your sample reaching the laboratory, with a GP report that explains each marker, estimates what they mean for your heart risk and sets out what to do next, including when to see your GP about treatment.