Cardio-Respiratory Health
Cardiovascular disease is the most studied area in medicine and still the one most commonly found too late. The gap is rarely knowledge; it is that the measurements which would have shown it were never taken, or were taken once and never repeated.
What this means for healthspan
Cardio-respiratory health is about how well your heart, blood vessels and lungs work together to deliver oxygen to your body. It is shaped by blood pressure, blood fats, fitness, smoking history, family history and other long-term factors.
Many of these factors cause no symptoms for years. Measuring them, and repeating the measurements over time, can help show whether your risk is rising and where changes may be most useful.
What we assess, and why
We may review blood pressure, lipid profile, cardiovascular risk factors, an ECG when indicated, and selected investigations such as ambulatory blood pressure monitoring, coronary calcium scoring or other cardiac imaging when clinically appropriate. Lung health is considered too, including spirometry when your symptoms, smoking history or other factors make it appropriate.
Identifying and managing modifiable risk factors can help reduce the likelihood of cardiovascular disease. Spirometry and imaging are not offered to everyone; we only suggest them where there is a clear reason and where the result could change what we do.
What we may assess
Blood pressure, lipid profile, cardiovascular risk factors, ECG when indicated, and selected investigations such as ambulatory blood pressure monitoring, coronary calcium scoring or other cardiac imaging when clinically appropriate. Lung function testing (spirometry) may be considered when symptoms, smoking history or other risk factors make it clinically appropriate. It is not offered as routine testing for everyone.
What is used is chosen for you, according to your individual risk, clinical appropriateness, the evidence and what you decide with your physician.
Why it matters
Identifying and managing modifiable risk factors can help reduce the likelihood of cardiovascular disease, and recognizing breathing problems early can guide further assessment.
Examples of assessments and investigations
These are examples of what may be considered. Which of them are used for you depends on your history, your risk and what you decide with your physician.
Blood pressure measurement
Checked in the clinic with proper technique. Hypertension Canada also supports home readings over several days to confirm a diagnosis and to avoid mistaking a nervous reading for ongoing high blood pressure.
Home or ambulatory blood pressure monitoring
Home monitoring uses a validated cuff for a week. A 24-hour ambulatory monitor records readings through a normal day and night. Either may be used to confirm high blood pressure or when clinic readings are unclear.
Lipid profile with ApoB and lipoprotein(a)
Measures cholesterol and related blood fats. ApoB may be useful when triglycerides are raised, and lipoprotein(a) is an inherited marker that Canadian guidance suggests measuring once.
Cardiovascular risk estimate
Combines age, sex, blood pressure, cholesterol, smoking, diabetes and family history into an estimated risk. It helps decide whether medicines or further tests are worth discussing.
Resting ECG
A short heart tracing. It is considered when you have symptoms, an irregular pulse, or specific risk factors, rather than for everyone without symptoms.
Coronary artery calcium scoring
A low-dose CT scan that measures calcium in heart arteries. It may be considered when risk is borderline and the result could help decide about preventive medicines. It involves radiation and is not routine.
Exercise testing or other cardiac imaging
Considered when symptoms, an abnormal ECG or particular risk factors suggest it. Referral to a cardiologist may be needed.
Spirometry
A short breathing test that shows how much air you can blow out and how fast. It may be considered if you have breathlessness, ongoing cough, asthma concerns, or are a current or former smoker. It is not a test for everyone.
Review of fitness, symptoms and lifestyle
Questions about breathlessness, chest discomfort, activity, smoking, alcohol, sleep and diet, which often tell us more than a single test.
What the evidence supports, and where it is uncertain
What the evidence supports
- High blood pressure and high cholesterol are well-established, treatable contributors to heart disease and stroke.
- Hypertension Canada supports confirming a diagnosis using home or ambulatory readings, which helps avoid unnecessary lifelong treatment.
- Canadian lipid guidance supports lipid testing for adults 40 and older and for younger adults with risk factors, and a one-time lipoprotein(a) measurement.
- Spirometry is the standard test to confirm COPD and to diagnose and manage asthma in people with symptoms or risk factors.
- Not smoking, regular physical activity, healthy eating and a healthy weight lower the risk of both heart and lung disease.
Limits and uncertainties
- Coronary calcium scoring helps refine risk in selected people but is not recommended as a routine test for everyone. A high score can lead to more tests, and a zero score does not rule out all heart disease.
- Resting ECGs in people without symptoms can show harmless variations that lead to further testing that was not needed.
- Spirometry in people without symptoms or risk factors has not been shown to improve outcomes. It is most useful when there is a reason to look.
- Blood pressure targets and thresholds can differ between guidelines and are updated over time. Your own targets depend on your health conditions.
- Imaging involves radiation or cost and can find incidental results of uncertain significance.
From findings to a plan, and what follows
How findings can inform a plan
Findings are combined into an overall picture of your cardiovascular and lung health and how it fits with your age, history and goals. A plan may include changes to activity, diet, sleep and smoking or alcohol use, and where appropriate a discussion about medicines for blood pressure or cholesterol. If a test suggests further assessment, we explain the reasons and the options so you can decide with us what makes sense.
Follow-up, monitoring and coordination
Follow-up may include repeat blood pressure readings, repeat blood tests at suitable intervals, and review of how any changes or treatments are working. If a finding needs specialist care, such as cardiology or respirology, we coordinate with your family doctor and share results with your permission. If you develop new chest pain, severe breathlessness, fainting or stroke symptoms, call 9-1-1 rather than waiting for a scheduled visit.
What happens here
The approach is the same in every area: establish where you are, change something on a cadence, then measure again to find out whether it worked. In cardio-respiratory health that work is organized into the programs below.
Cardiovascular Prevention
Detailed risk assessment, and prevention that follows from it.
What this involves
Reliable places to read more
These are independent organizations. Monarch Health does not control their content and has no arrangement with them.
Heart & Stroke
High blood pressure(opens in a new tab)
Heart & Stroke
Heart disease risk and prevention(opens in a new tab)
Hypertension Canada
Public blood pressure resources, including home monitoring and validated devices(opens in a new tab)
Canadian Lung Association
Spirometry(opens in a new tab)
Canadian Lung Association
Chronic obstructive pulmonary disease (COPD)(opens in a new tab)
Where to go next
The other areas we work on