How to Understand the Results of Your Checkup

When you visit your doctor for a routine physical, you probably have your pulse measured, your blood pressure taken, your weight checked, and your blood drawn. Wondering why these procedures are performed, and what they mean? Hereís a guide to what your doctor will be doing at your checkup, and how to interpret the findings.

First Things First: Your Medical History

At a checkup, your doctor will want to know both your past medical history and that of your close relatives. "Family history is very important," says Sam Altstein, DO, of Mount Sinai Medical Center in New York City. "It helps the doctor decide when to order various screenings, since your risk for certain disorders may be elevated if you have a first degree relative who had it."

A social, or lifestyle history is also important. "I want to know what you do to take care of yourself," Alstein says. "Are you sedentary, do you smoke? A patientís lifestyle can help me predict some modifiable risks," that is, risks you can lower.

Expect These Routine Screenings

Blood Pressure. A normal blood pressure reading is less than 120/80 mm Hg, according to Altstein. The top number, systolic blood pressure, is the measure of the maximum amount of pressure in your arteries when your heart contracts to pump blood through your circulatory system. The bottom number, diastolic blood pressure, is the measure of the minimum amount of pressure in your arteries when the heart is at rest, after it contracts, explains Altstein.

Prehypertension (higher than normal blood pressure) is from 120 to 139/80 to 89. If your blood pressure reading is greater than 140/90, you have high blood pressure, or hypertension. The risks of hypertension include stroke, heart attack, heart failure, kidney failure, and blindness, says Altstein.

Blood Glucose Levels. Your fasting (no food or drink for at least eight hours) blood glucose (blood sugar) should be 99 or less. If itís 100 to 126, this is considered prediabetes. If itís 127 or higher, you likely have diabetes, so your doctor should have you return to the office for repeat testing in a few weeks. If your fasting blood glucose is greater than 200, you have diabetes.

Another important blood test that your doctor can perform to screen you for diabetes is a Hemoglobin A1C. This blood test measures the average blood glucose over the past 90 days. The advantage of this test is that the patient does need to be in the fasting state. A normal level is level is less than or equal to 5.6. In individuals with prediabetes, the level is 5.7 to 6.4. A level higher than 6.5 is indicative of diabetes. Diabetes is associated with a number of health problems, including heart disease.

"When someone comes in with an abnormal blood glucose or blood pressure, we educate the patient about what their lab tests means and focus on lifestyle modifications with regards to improving diet and exercise and achieving a normal body weight," Altstein explains. Medications to lower blood glucose might be prescribed, depending on how high the patientís blood glucose is.

Cholesterol Levels. Your routine blood work will include a screening for the following:

  • Total cholesterol: Normal is under 200.
  • LDL (low density lipoprotein, or ďbadĒ) cholesterol: Normal is under 130.
  • HDL (high density lipoprotein, or ďgoodĒ) cholesterol: Normal is greater than 50.
  • Triglycerides (a type of fat in the blood): Normal is 150 or less.

"If youíre not having any symptoms, your doctor will only order these baseline blood tests," Nieca Goldberg, MD, director of the Joan H. Tisch Center for Womenís Health at NYU Langone Medical Center in New York City. High blood cholesterol is dangerous because itís one of the major risk factors for stroke, heart attack, and coronary heart disease, according to the American Heart Association. Your risk of coronary heart disease increases as your cholesterol rises.

Electrocardiogram or EKG. This simple test, also called an EKG, records the heartís electrical activity and helps doctors to diagnose heart attacks and arrhythmias. Men with no symptoms of heart disease will be advised to have an EKG at 40, while women with no symptoms will be told to have one between the ages of 45 and 50, Goldberg says.

Keeping Your Eyes Healthy

If youíre under age 40 and donít wear contact lenses or eyeglasses, you can schedule an eye exam every two years, says Lisa Park, MD, chief of staff at Bellevue Hospital in New York City. Your doctor will check for the presence of glaucoma or cataracts, and do a routine vision screening, she explains. Cataracts, a clouding of the lens of the eye that can impair your vision, are common in older people and mostly related to aging, according to the National Eye Institute in the National Institutes of Health. The group of diseases known as glaucoma can result in vision loss and blindness but early detection and treatment can protect the eyes against severe vision loss, according to the National Eye Institute.

"Over age 40, we recommend that you get an annual eye exam," she says. "And if you are younger and have any other medical conditions such as diabetes or high blood pressure, we recommend annual visits to the doctor."

Once you turn 60, your doctor will want to see you every year to check whether you have macular degeneration, a condition in which the retina becomes damaged and results in the loss of vision in the center of the visual field.

Cancer Screenings

  • For women. Itís generally recommended that women begin to have mammograms once a year starting at age 40, says Fahimeh Sasan, MD, assistant professor of obstetrics, gynecology, and reproductive medicine at Mount Sinai Medical Center in New York City. "Women with a family history of breast cancer should discuss their individual case with their gynecologist to determine the best age to initiate mammograms, as well as how often they should be performed," she says. "Depending on their family history their gynecologist may refer them to a genetic counselor for BRCA [a gene mutation associated with an increased risk of breast cancer] testing."
  • For men. A blood test called the prostate specific antigen (PSA) may be done to detect prostate cancer, although itís not routinely performed. "They thought that this would help detect prostate cancer early," says Nirav Vakharia, MD, of the Cleveland Clinic. "But then they realized that it was not a very good blood test and the current guidelines are for men, at age 50, to have a discussion with their doctor to see if they should be screened at all."

Nieca Goldberg, MD, reviewed this article.

Sources

Sam Altstein, MD. Phone interview on January 21, 2015.

Nieca Goldberg, MD. Phone interview on January 20, 2015.

Lisa Park, MD. Phone interview on January 20, 2015.

Fahimeh Sasan, MD. Email interview on January 20, 2015.

Nirav Vakharia, MD. Phone interview on January 21, 2015.

"Why Cholesterol Matters." American Heart Association. Page last reviewed April 21, 2014.

"Facts About Cataract." National Eye Institute. Page last reviewed September 2009.

"Facts About Glaucoma." National Eye Institute. Page accessed February 17, 2015.

"Long-Term Trial Results Show No Mortality Benefit from Annual Prostate Cancer Screening." National Cancer Institute. Page last reviewed February 17, 2012.