Have you heard of the 45 – 49-year-old health check?

Woman and man on a checked picnic rug in front of a tent. They are reading a map, and a small dog is next to them. The background is dense green trees.

Are you 45 – 49 years old? Did you know that you are eligible for a free health check?

Do you know what sort of health screening you should be doing at this age?

Are there any differences between men and women and what we should be looking for at this age?

Chat to your GP about what you should be screening for at this age. Some of the things your GP will discuss with you are:

Cholesterol

  • For most Caucasians, we start testing cholesterol levels at 45 years.

  • For Asians, screening often starts earlier, around 35 years of age.

  • Whether or not your cholesterol needs to be lowered.

  • This will depend on whether anyone in your family including yourself has ever had any heart disease, blood pressure problems or strokes.

  • The difference between good and bad cholesterol

  • The ratio of good to total cholesterol and why this is more important than your

  • total level of cholesterol.

  • This is measured via a fasting blood test

  • Fasting means nothing to eat or drink except for water for at least 8 hours before the blood test

Blood pressure

What your blood pressure should be and whether or not yours needs to be lowered

This can be measured in the doctors’ office

Normal blood pressure is 120/80 mmHg

120 mmHg is the pressure the heart generates when it contracts and 80 mmHg is the pressure in the heart when it relaxes

Electrocardiograph (ECG)

Measurement of the electronic activity of the heart

Determines whether there has been a previous heart attack, a rhythm abnormality of the heart, strain on the heart due to elevated blood pressure or any other abnormalities

This is done in the doctors’ office

Diabetes risk

What your fasting blood sugar is

What your sugar levels are over a 3-month period and why this gives a more accurate indication of risk of diabetes.

What your risk of diabetes is given your family history and other personal risk factors.

This is done with a fasting blood test.

Cardiovascular risk assessment begins at 45 years of age

Your GP can discuss with you how this is calculated, what this means and whether or not you need to consider losing weight, increasing your exercise levels, altering your diet, further heart testing with a heart specialist and/or whether you need to consider lowering cholesterol levels or blood pressure or both.

This is done using a calculation taking into account your age, whether or not you smoke, your weight, height, results of your blood tests and an ECG.

Basic Bloods

Kidney function, liver function, thyroid function, cholesterol, sugar, cholesterol, iron levels, vitamin D.

This is done via a blood test.

Mental health

Life is so fast paced. Sometimes, when we stop and actually think about how we are feeling, it might not be as good as we thought

There is a lot your doctor can suggest for you to help in this department .

This is done via a questionnaire in the doctors’ office.

Skin check

Australia has the highest skin cancer rates in the world.

Whilst we recommend Australians have annual skin checks from the age of 25 years; often this does not happen and 45 years is when we, as doctors are given the opportunity to see patients’ and offer this service.

At the moment, the absolute best treatment we can offer for skin cancer is prevention. After this; early diagnosis and removal before spread can occur.

Skin checks are done in the doctors’ office.

Not all of LGP's doctors specialise in this. Just ask at reception and you will be directed to the doctors who do offer this service.

Breast check

Usually mammograms commence at age 50 years; however, they are offered via BreastScreen from 40 years of age and there are times when your GP will recommend you start screening early. E.g. if you have a family history of breast cancer or ovarian cancer or if you have very dense breasts.

Your GP can teach you how to examine your own breasts or offer an in-office breast examination.

There is currently no evidence that your GP doing a clinical breast examination will increase the chances of finding an early breast cancer.

If your GP feels you should start breast screening early, they will likely refer you for a mammogram (X ray of the breasts) and an ultrasound of both breasts. This is because over the age of 50 years a mammogram is the most accurate form of imaging and under the age of 35 years, an ultrasound is the most accurate form of imaging. For 45 – 49 years, it is most accurate to do both forms of imaging

Mammograms are free from the age of 40 years but ultrasound will incur a small cost.

Pap smear

This can now be done every 5 years as we now test for Human Papilloma Virus (HPV) DNA HPV causes 99.8% of all cervical cancer.

If your pap smear comes back with an abnormality, this can often be dealt with very easily with either a “watch and wait” approach or referral to a gynaecologist.

This is done in the doctors’ office.

Contraception and perimenopausal symptoms

These are other things your doctor can discuss with you and help you to .

References

RACGP Red Book Guidelines

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