Age 40 is a prompt for a risk conversation, not a diagnosis
NICE recommends ongoing review of cardiovascular-risk estimates for people over 40. For adults aged 25 to 84 without established cardiovascular disease, NICE recommends QRISK3 for estimating 10-year cardiovascular risk. A clinician should discuss the assessment with you and use clinical judgement alongside any score.[2]
The NHS Health Check: a useful starting point
The NHS Health Check is a free cardiovascular-health check for eligible people in England aged 40 to 74. It is intended for people without certain pre-existing cardiovascular conditions and is offered every five years. It usually includes height and weight, waist measurement, blood pressure, a cholesterol test and sometimes a blood sugar test, alongside questions about health and lifestyle.[1]
The check can help you discuss your cardiovascular-risk score and possible ways to reduce risk. It does not replace symptom assessment, monitoring for an existing condition, or care from the clinician who knows your medical history.[1]
What should guide test selection?
A useful question before any blood test is: “What decision could this result help the clinician and me make?” A test is more useful when it fits a symptom, an established condition, a medicine-monitoring plan, or a defined risk discussion.
| Consideration | Why it matters | A practical step |
|---|---|---|
| Cardiovascular risk | Blood pressure, cholesterol, diabetes risk, smoking, family history and other factors can contribute to a wider risk discussion. | The NHS Health Check and NICE cardiovascular guidance provide a useful starting framework. |
| Symptoms | Tiredness, weight change, bleeding changes, thirst, urinary symptoms or other concerns may change which tests are appropriate. | Tell the clinician what has changed and when it started. A symptom-led assessment is different from routine testing. |
| Existing conditions and medicines | A known condition or a medicine may need specific monitoring. | Follow the monitoring plan agreed with your own clinician rather than using an age-based checklist. |
| Family history | A family history may affect the questions a clinician asks and the assessment they recommend. | Share relevant family history, including age at diagnosis where you know it. |
Tests may be considered for a specific reason
Blood tests can investigate symptoms, monitor a treatment or condition, or contribute to a risk assessment. The NHS lists examples including full blood count, blood glucose, renal tests, lipid profile and thyroid-stimulating hormone. Which, if any, are appropriate depends on the question being asked.[1]
If you have symptoms
Describe the symptom, when it began, how it affects you and any change in severity. Your clinician can decide whether testing or another assessment is the better next step.
If you have no symptoms
Use an NHS Health Check or a clinician-led risk discussion to decide whether any test will add useful information for you.
Vitamin, hormone, tumour-marker and advanced cardiovascular tests are not routine for everyone at 40. Ask what a test is intended to investigate, what its limits are and how the result would affect your care.
Preparing for the conversation
Take a list of medicines, relevant results, diagnoses and family history. Mention any symptoms, including whether they are new or worsening. If you choose a private route, the clinic confirms the appropriate appointment, preparation, test availability, reporting and follow-up arrangements at booking.
Private blood tests
Explore test appointment pathways
Private health checks
Read about health-check options
Cholesterol numbers
Understand cardiovascular risk context
Private GP
Discuss symptoms and suitable next steps
Seek urgent help for urgent symptoms
Routine testing is not a substitute for urgent care. If you think you need medical help now, use NHS 111. Call 999 for a life-threatening emergency.[3]
Frequently asked questions
Should every person have the same blood tests at 40?
No. The right tests depend on your symptoms, health history, family history, medicines and existing conditions. Age can prompt a conversation about risk, but it does not create a universal testing panel.
Is an NHS Health Check available at 40?
In England, NHS Health Checks are for people aged 40 to 74 who do not have certain pre-existing cardiovascular conditions. Eligible people should be invited every five years. If you think you are eligible and have not been invited, contact your GP practice or local council.
Does an NHS Health Check include a blood test?
The NHS says the check usually includes a cholesterol test and may include a blood sugar test. You may be asked to have a blood test at or before the appointment. The assessment also includes non-blood-test information such as blood pressure and lifestyle questions.
Should I arrange vitamin, hormone or advanced cardiovascular tests at 40?
Only if there is a clinical reason to consider them. These tests are not a routine substitute for a symptom and risk assessment. Ask a clinician what question a proposed test is intended to answer and how the result would affect care.
How often should I repeat blood tests?
Repeat testing depends on the reason for the test, any result, symptoms, medicines and an agreed care plan. A clinician can advise on an interval that is appropriate for you.
References
- [1] NHS. NHS Health Check. Accessed 30 August 2026. View source
- [2] National Institute for Health and Care Excellence. Cardiovascular disease: risk assessment and reduction, including lipid modification (NG238). Recommendations 1.1.1 to 1.1.18. Accessed 30 August 2026. View source
- [3] NHS. When to use NHS 111 online or call 111. Accessed 30 August 2026. View source